COL4A1-related brain small-vessel disease, Intracranial Cortical Calcifications

What is COL4A1 disease?
COL4A1-related brain small-vessel disease is characterized by weakening of the blood vessels in the brain. Stroke is often the first symptom of this condition, typically occurring in mid-adulthood.

What is the COL4A1 gene?
The COL4A1 gene provides instructions for making one component of type IV collagen, which is a flexible protein important in the structure of many tissues throughout the body. Specifically, this gene makes the alpha1(IV) chain of type IV collagen.

Patients with chronic parathyroid dysfunction often have intracranial calcification in deep gray matter (GM) and subcortical white matter

What are the symptoms of brain calcification?
Muscle cramping (dystonia), uncontrollable spasmodic irregular movements (chorea), and seizures can also occur. Occasional symptoms include sensory changes, headaches and urinary incontinence. Associated symptoms include loss of contact with reality (psychosis), mood swings and loss of acquired motor skills.

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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

Assessment of periodontitis grade in epidemiological studies using interdental attachment loss instead of radiographic bone loss

alexandrossfakianakis shared this article with you from Inoreader Assessment of periodontitis grade in epidemiological studies using interdental attachment loss instead of radiographic bone loss via Journal of Clinical Periodontology Abstract Objective Comparison of grading according to radiographic bone loss (BL) or according to interdental clinical attachment loss (CAL). Methods In 100 periodontitis patients of the Department of Periodontology of Goethe-University Frankfurt, Germany periodontitis grade was assigned by i) indirect evidence using BL at the most affected tooth divided by root length and ii) CAL at the most affected tooth divided by root length of the respective tooth type according to root length in German and Swedish cohorts. Resulting quotients were divided by age. Results Patients (age: 53.5±10.4 years; 57 females; 16 smokers; no diabetes; stage 78 III, 22 IV) were by either method assigned to grade B or C (BL: 35 B, 65 C; CAL [German]: 23 B, 77 C; [Swedish]: 29 B, 71 C). Using root length (German cohort), agreement was 76% (kappa: 0.427; fair to good /moderate agreement) and 72% (Swedish cohort; kappa: 0.359; poor agreement/fair). Molars were most frequently chosen (BL: 64%; CAL: 71%). Conclusions Assignment of periodontitis grade by indirect evidence using BL or CAL using standard root length of the German cohort showed fair to good/moderate agreement. Thus, grade assignment by CAL may be used in epidemiologic studies where radiographs are not available. View on Web

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Soft and hard tissue changes after immediate implant placement with or without a sub‐epithelial connective tissue graft: results from a 6‐months pilot randomized controlled clinical trial

alexandrossfakianakis shared this article with you from Inoreader Soft and hard tissue changes after immediate implant placement with or without a sub‐epithelial connective tissue graft: results from a 6‐months pilot randomized controlled clinical trial via Journal of Clinical Periodontology Abstract Aim The present pilot RCT aimed to investigate the influence of a connective tissue graft (CTG) in combination with the immediate implant placement (IIP) on hard and soft tissues healing, without a bone replacement graft in the gap between the implant and the socket walls. Material and Methods Thirty patients requiring extraction of one anterior tooth (from premolar to premolar) were randomly assigned to one of the two treatment groups (test: IIP+CTG; control: IIP). Cone-beam computed tomography (CBCT) and optically scans were performed before tooth extraction and at 6-months follow-up. Then, DICOM files were superimposed in order to allow the evaluation of osseous ridge and buccal bone changes, while the superimposition of DICOM and STL (Standard Tessellation Language) files allowed for evaluating of soft tissue contour. For testing the differences between the two groups, the non-parametric test as Wilcoxon rank-sum test, was used. Results Twenty-six out of the thirty enrolled patients, attended the 6-month follow-up visit. The 4 patients of control group that were lost to follow-up, were analyzed under the intention-to-treat principle. No statistically significant differences between the groups were observed for the vertical buccal bone resorption (p=0.90), as well as for the horizontal buccal bone resorption at all measured levels. Significant differences were found between test and control groups in the horizontal dimensional changes of osseous ridge at the most coronal aspect (p=0.0003 and p=0.02). Changes of tissue contour ranged between -0.32 and -0.04 mm in the test group, and between -1.94 and -1.08 mm in the control group, while changes of soft tissue thickness varied between 1.33 and 2.42 mm in the test group, and between -0.16 and 0.88 mm in the control group, with statistically significant differences for both variables at all measured levels. At 6 months, the mean volume inc rease was 6.76±8.94 mm3 and 0.16±0.42 mm3 in the test and control groups, respectively, with statistically significant difference. Conclusions The findings of the present study indicate that the adjunct of a connective tissue graft at the time of immediate implant placement, without bone grafting, does not influence vertical bone resorption. Within the limits of the present study, it can be suggested that the adjunct of a connective tissue graft at the time of immediate implant placement, without bone grafting, reduces the horizontal changes of the alveolar ridge. Moreover, it allows maintenance of the tissue contour due to an increase in soft tissue thickness. View on Web

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Lingual Frenectomy Criteria

The term free-tongue is defined as the length of tongue from the insertion of the lingual frenum into the base of the tongue to the tip of the tongue. Clinically acceptable, normal range of free tongue is greater than 16 mm. 

The ankyloglossia can be classified into 4 classes based on Kotlow's assessment as follows; 

Class I: Mild ankyloglossia: 12 to 16 mm, 

Class II: Moderate ankyloglossia: 8 to 11 mm, 

Class III: Severe ankyloglossia: 3 to 7 mm, 

Class IV: Complete ankyloglossia: Less than 3 mm.2 

Class III and IV tongue-tie category should be given special consideration because they severely restrict the tongue's movement. A normal range of motion of the tongue is indicated by the following criteria: The tip of the tongue should be able to protrude outside the mouth; without clefting, the tip of the tongue should be able to sweep the upper and lower lips easily; without straining, when the tongue is retruded, it should not blanch the tissues lingual to the anterior teeth; and the lingual frenum should not create a diastema between the mandibular central incisors.

Ankyloglossia was also found associated in cases with some rare syndromes such as X-linked cleft palate syndrome, Kindler syndrome, van der Woude syndrome, and Opitz syndrome.Nevertheless, most ankyloglossias are observed in persons without any other congenital anomalies or diseases.

The difficulties in articulation are evident for consonants and sounds like "s, z, t, d, l, j, zh, ch, th, dg" and it is especially difficult to roll an "r".

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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

Effectiveness of Tongue‐tie Assessment Tools in Diagnosing and Fulfilling Lingual Frenectomy Criteria: A Systematic Review

alexandrossfakianakis shared this article with you from Inoreader Effectiveness of Tongue‐tie Assessment Tools in Diagnosing and Fulfilling Lingual Frenectomy Criteria: A Systematic Review via Australian Dental Journal ABSTRACT It is unclear how effective tongue-tie classification assessment tools are in diagnosing symptomatic tongue-tie and fulfilling lingual frenectomy criteria. The purpose of this systematic review is to determine and evaluate any association between tongue-tie severity, as measured by pre-treatment assessment tools, and post-operative outcome following tongue-tie division. PubMed, EMBASE, and the Cochrane search engines were used to retrieve articles published between 1947 and 2021. Included studies consisted of patients with symptomatic tongue-tie, assessment by either the Coryllos, Kotlow, or Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF) classification tool, and tongue-tie division. A total of 205 abstracts were identified; 31 studies met the criteria for a full-text review, of which, only 14 studies met the criteria for data extraction and analysis. Six studies used the HATLFF, 2 studies used the Kotlow, 5 studies used the Coryllos, and 1 study used a combinati on of both Kotlow and Coryllos methods. Significant heterogeneity was evident across all studies. No statistical correlation between the two variables could be determined. Although tongue-tie division procedures appear to provide benefits in breastfeeding and speech, there are no data to suggest a statistically significant association between the severity of tongue-tie, and the correct identification of patients who would benefit from tongue-tie division. © 2022 Australian Dental Association. View on Web

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Effect of three different remineralizing agents on artificial erosive lesions of primary teeth

alexandrossfakianakis shared this article with you from Inoreader Effect of three different remineralizing agents on artificial erosive lesions of primary teeth via Australian Dental Journal ABSTRACT Background This study aimed to investigate the efficacy of three remineralizing agents on dental erosion in primary teeth. Methods Forty primary molars were randomly divided into four groups (n = 10 each): self-assembling peptide (P11-4), casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP), sodium fluoride (NaF), and artificial saliva (AS; control). The erosion-like formation was created by immersing the samples in citric acid (4 × 2 min, pH 2.3) and AS (4 × 2 h, pH 7). The eroded samples were then treated with remineralizing agents and subjected to further erosion consisting of 15 cycles (3x/8-h interval) of immersion in citric acid and AS for 6 s each. Alterations in the mineral content and morphology of the samples were quantified using a microhardness tester and atomic force microscope. Results All agents had a significant remineralization effect on eroded primary tooth enamel. After further erosive challenge, enamel loss in the CPP-ACFP group was found to be significantly lower than in all other groups, and no significant difference was found between the P11-4 and NaF groups. Conclusions This study demonstrated that all tested materials had remineralization ability, and CPP-ACFP had a superior effect in inhibiting enamel loss due to dental erosion in primary teeth. © 2022 Australian Dental Association. View on Web

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African American race as a risk factor associated with a second primary lung cancer after initial primary head and neck cancer

alexandrossfakianakis shared this article with you from Inoreader African American race as a risk factor associated with a second primary lung cancer after initial primary head and neck cancer via Head & Neck Abstract Background Initial primary head and neck cancer (IPHNC) is associated with second primary lung cancer (SPLC). We studied this association in a population with a high proportion of African American (AA) patients. Methods Patients with IPHNC and SPLC treated between 2000 and 2017 were reviewed for demographic, disease, and treatment-related characteristics and compared to age-and-stage-matched controls without SPLC. Logistic and Cox regression models were used to analyze the relationship of these characteristics with the development of SPLC and overall survival (OS). Results Eighty-seven patients and controls were compared respectively. AA race was associated with a significantly higher risk of developing SPLC (OR 2.92, 95% CI 1.35–6.66). After correcting for immortal time bias, patients with SPLC had a significantly lower OS when compared with controls (HR 0.248, 95% CI 0.170–0.362). Conclusions We show that AA race is associated with an increased risk of SPLC after IPHNC; reasons of this increased risk warrant further investigation. View on Web

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Effect of new biological patch in repairing intrauterine adhesion and improving clinical pregnancy outcome in infertile women: study protocol for a randomized controlled trial

alexandrossfakianakis shared this article with you from Inoreader Effect of new biological patch in repairing intrauterine adhesion and improving clinical pregnancy outcome in infertile women: study protocol for a randomized controlled trial via Trials - Latest Articles Endometrial fibrosis caused by intrauterine adhesion (IUA) can lead to hypomenorrhea, amenorrhea, and even infertility and abortion. The postoperative recurrence rate of severe IUA remains high, giving rise to... View on Web

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Old age amyotrophic lateral sclerosis and limbic TDP‐43 pathology

alexandrossfakianakis shared this article with you from Inoreader Old age amyotrophic lateral sclerosis and limbic TDP‐43 pathology via Brain Pathology Regional pTDP-43 lesion burden in young-ALS and old-ALS box plots shows regional TDP-43 burden in young-, middle-, and old-ALS. The line in box plots represents the median. Old-ALS cases had greater TDP-43 burden in amygdala (p < 0.001), dentate gyrus (p < 0.05), CA1 (p < 0.01), subiculum (p < 0.01), and entorhinal cortex (p < 0.01) compared with young-ALS and middle-ALS. There is no difference between the three groups in the middle frontal cortex and white matter of the parahippocampal gyrus. ***p < 0.001, **p < 0.05, *p < 0.01. p Values are from one-way ANOVA Abstract This study aimed to assess and compare the burden of transactive response DNA-binding protein of 43 kDa (TDP-43) pathology and clinical features of amyotrophic lateral sclerosis (ALS) in three age groups. All cases were from the Mayo Clinic brain bank for neurodegenerative disorders and most were followed longitudinally in the ALS Clinic. Cases with moderate-to-severe Alzheimer's disease neuropathological change were excluded. The 55 cases included in the study were divided into three groups by age at death: 75 years or older (old-ALS, n = 8), 64–74 years (middle-ALS, n = 23), and 63 years or younger (young-ALS, n = 24). Clinical features, including disease duration, initial symptoms, and ALS Cognitive Behavior Score (ALS-CBS), were summarized. Sections of paraffin-embedded tissue from the motor cortex, basal forebrain, medial temporal lobe, and middle frontal gyrus were processed for phospho-TDP-43 immunohistochemist ry. The burden of TDP-43 pathology was analyzed using digital image analysis. The TDP-43 burden in the limbic system (i.e., amygdala, dentate gyrus and CA1 sector of the hippocampus, subiculum, and entorhinal cortex) was greater in old-ALS than in young-ALS and middle-ALS. TDP-43 burden in the middle frontal gyrus was sparse and did not differ between the three groups. The average of ALS-CBS was not different between the three groups. The present study shows that the amygdala and hippocampus are vulnerable to TDP-43 pathology in older patients with ALS. We discuss the evidence for and against this pathology being related to concurrent limbic-predominant, age-related TDP-43 encephalopathy neuropathologic change. View on Web

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Prevalence, outcome, and prevention of congenital cytomegalovirus infection in neonates born to women with preconception immunity (CHILd study).

alexandrossfakianakis shared this article with you from Inoreader Prevalence, outcome, and prevention of congenital cytomegalovirus infection in neonates born to women with preconception immunity (CHILd study). via Clinical Infectious Diseases Advance Access Abstract Background Human cytomegalovirus (HCMV) is the leading infectious cause of congenital disabilities. We designed a prospective study to investigate the rate, outcome and risk factors of congenital cytomegalovirus infection (cCMV) in neonates born to immune women, and the potential need and effectiveness of hygiene recommendations in this population. Methods The study (NCT03973359) was composed of 2 sequential parts: an epidemiology (Part 1) and a prevent ion (Part 2) study. Performance of Part 2 depended upon a cCMV rate > 0.4%. Women enrolled in Part 1 did not receive hygiene recommendations. Newborns were screened by HCMV DNA testing in saliva and cCMV was confirmed by urine testing. Results Saliva swabs were positive for HCMV DNA in 45/9661 newborns and cCMV was confirmed in 18 cases. The rate of cCMV was 0.19% (95% CI: 0.11-0.29%), and three out of 18 infants with cCMV had symptoms of CMV at birth. Age, nationality, occupation and contact with children were similar between mothers of infected and non-infected newborns. Twin pregnancy (OR: 7.2; 95% CI 1.7-32.2; p = 0.037) and maternal medical conditions (OR: 3.9; 95% CI: 1.5-10.1; p = 0.003) appeared associated with cCMV. Given the rate of cCMV lower than expected, the prevention part of the study was cancelled. Conclusion Newborns from women with preconception immunity have a low rate of cCMV, which appears to be mostly due to reactivation of the latent virus. Therefore, serological screening in childbearing age would be pivotal to identify HCMV-seropositive women, whose newborns have a low risk of cCMV. View on Web

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Life-Threatening Complications of Influenza versus COVID-19 in U.S. Children

alexandrossfakianakis shared this article with you from Inoreader Life-Threatening Complications of Influenza versus COVID-19 in U.S. Children via Clinical Infectious Diseases Advance Access ABSTRACT Background Clinical differences between critical illness from influenza infection versus coronavirus disease 2019 (COVID-19) have not been well characterized in pediatric patients. Methods We compared U.S. children (8 months to 17 years) admitted to the intensive care or high acuity unit with influenza (17 hospitals, 12/19/2019–3/9/2020) or COVID-19 (52 hospitals, 3/15/2020–12/31/2020). We compared demographics, underlying conditions, clinical prese ntation, severity, and outcomes. Using mixed-effects models, we assessed the odds of death or requiring life-support for influenza versus COVID-19 after adjustment for age, sex, race and Hispanic origin, and underlying conditions including obesity. Results Children with influenza (n = 179) were younger than those with COVID-19 (n = 381; median 5.2 vs. 13.8 years), less likely to be non-Hispanic black (14.5% vs. 27.6%) or Hispanic (24.0% vs. 36.2%), and less likely to have ≥1 underlying condition (66.4% vs. 78.5%) or be obese (21.4% vs. 42.2%). They were similarly likely to require invasive mechanical ventilation (both 30.2%), vasopressor support (19.6% and 19.9%), or extracorporeal membrane oxygenation (2.2% and 2.9%). Four children with influenza (2.2%) and 11 children with COVID-19 (2.9%) died. The odds of death or requiring life-support in children with influenza vs. COVID-19 were s imilar (adjusted odds ratio, 1.30 [95% CI: 0.78–2.15; P = 0.32]). Median duration of hospital stay was shorter for influenza than COVID-19 (5 versus 7 days). Conclusions Despite differences in demographics and clinical characteristics of children with influenza or COVID-19, the frequency of life-threatening complications was similar. Our findings highlight the importance of implementing prevention measures to reduce transmission and disease severity of influenza and COVID-19. View on Web

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