Association between periodontitis and chronic kidney disease by functional atherosclerosis status among older Japanese individuals: a cross‐sectional study

alexandrossfakianakis shared this article with you from Inoreader Association between periodontitis and chronic kidney disease by functional atherosclerosis status among older Japanese individuals: a cross‐sectional study via Journal of Clinical Periodontology Abstract Aims This study aimed to clarify the influence of functional atherosclerosis on the association between periodontitis and chronic kidney disease (CKD). Methods A cross-sectional study of 998 older Japanese individuals aged 60–99 years who participated in an oral health check-up was conducted. Early and advanced periodontitis were defined as periodontal pocket depth 4.0–5.9 mm and ≥6.0 mm, respectively. Functional atherosclerosis was defined as cardio-ankle vascular index (CAVI) ≥9.0. Results Of the 998 study participants, 238 (23.8%) had CKD. No significant associations between periodontitis and CKD were observed in participants without functional atherosclerosis. After adjusting for known cardiovascular risk factors, the odds ratio (OR) (95% confidence interval [CI]) was 1.31 (0.81, 2.11) for early periodontitis and 0.74 (0.41, 1.34) for advanced periodontitis. Significant positive associations were observed for participants with functional atherosclerosis; the adjusted ORs (95%CIs) were 1.76 (1.04, 3.01) for early periodontitis and 1.95 (1.05, 3.63) for advanced periodontitis, respectively. Conclusions A significant positive association between periodontitis and CKD was established for older participants with functional atherosclerosis. No significant associations were observed for those without functional atherosclerosis. These results can help clarify the influence of periodontitis on systemic circulation. View on Web

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Outcomes of Periodontal therapy in Rheumatoid Arthritis: the OPERA feasibility randomised trial

alexandrossfakianakis shared this article with you from Inoreader Outcomes of Periodontal therapy in Rheumatoid Arthritis: the OPERA feasibility randomised trial via Journal of Clinical Periodontology Abstract Background Periodontitis is independently associated with rheumatoid arthritis (RA); however, there are limited data on whether periodontal treatment improves overall RA disease activity. We conducted a pilot feasibility randomised controlled clinical trial to test whether intensive periodontal therapy reduces RA disease activity in patients with active RA and periodontitis. Methods The following inclusion criteria were applied: patients with RA and periodontitis, aged 18+, stable on treatment with DMARDs for ≥ 3 months, disease activity score (DAS28) ≥3.2, and DAS28 >5.1 only if patient unwilling to take biologics. Participants meeting the inclusion criteria were randomised to immediate intensive periodontal therapy or to delayed therapy (control group) administered by a dental hygienist in a secondary care setting. Data were collected at baseline, 3 and 6 months of follow-up. Participants randomised to the control group (delayed therapy) received the standard of care for the duration of the trial, including oral hygiene instructions delivered by a dental hygienist, and the same periodontal therapy as the intervention group after study completion (i.e., 6 months after randomisation). The periodontal inflammation surface area (PISA) was calculated using clinical attachment loss, periodontal probing pocket depth and bleeding on probing. Cumulative pro bing depth was also measured. We examined the effect of periodontal therapy on periodontal outcomes and on clinical markers of disease activity in RA, as measured by the DAS28-CRP score and musculoskeletal ultrasound grey scale and power Doppler scores. Results A total of 649 patients with RA were invited to participate in the study. Of these, 296 (46%) RA patients consented to participate in the screening visit. A sample of 201 were assessed for eligibility, of whom 41 (20%) did not meet RA inclusion criteria and 100 (50%) did not meet periodontal disease (PD) criteria. Amongst 60 (30%) eligible participants, 30 were randomised to immediate periodontal therapy and 30 were allocated to the control group. The loss to follow-up was 18% at the end of the trial. There were no major differences with regards to baseline characteristics between groups. Periodontal therapy was associated with reduced periodontal inflamed surface area, cumulative probing depths, RA disease activity scores and ultrasound scores over the course of the trial. There was no change in clinical attachment loss. Conclusions Overall, the trial was feasible and acceptable to study participants. Recruitment and satisfactory retention into a randomised controlled trial on the effect of periodontal treatment on RA patients is possible, albeit challenging. In this feasibility study of patients with RA and periodontitis, periodontal treatment resulted in significant improvements in periodontal disease outcomes and overall RA disease activity, although complete resolution of periodontal inflammation was difficult to achieve in some cases. This article is protected by copyright. All rights reserved. View on Web

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Periodontitis is associated with the development of fungal sinusitis: A nationwide 12‐year follow‐up study

alexandrossfakianakis shared this article with you from Inoreader Periodontitis is associated with the development of fungal sinusitis: A nationwide 12‐year follow‐up study via Journal of Clinical Periodontology Abstract Aims The incidence of fungal sinusitis is increasing; however, its pathophysiology has not been investigated previously. This study investigated the effect of periodontitis on the incidence of fungal sinusitis over a 12-year follow-up period using nationwide, population-based data. Materials and Methods The periodontitis group was randomly selected from the National-Health-Insurance-Service database. The non-periodontitis group was obtained by propensity score matching considering several variables. The primary end point was the diagnosis of sinonasal fungal balls and invasive fungal sinusitis. Results The periodontitis and non-periodontitis groups included 12442 and 12442 individuals, respectively. The overall adjusted hazard ratio (aHR) for sinonasal fungal balls in the periodontitis group was 1.46 (p=0.002). In subgroup analysis, the aHR for sinonasal fungal balls was 1.59 (p=0.008) for those with underlying chronic kidney disease (CKD), 1.58 (p=0.022) for those with underlying atopic dermatitis, 1.48 (p=0.019) for those with chronic obstructive pulmonary disease (COPD), and 1.36 (p=0.030) for those with diabetes mellitus (DM), but these values are only applicable when considering the relationship between periodontitis and SFB. The aHR for invasive fungal sinusitis (IFS) in the periodontitis group was higher than in the non-periodontitis group (2.80; p=0.004). Conclusions The risk of sinonasal fungal balls and IFS increased after diagnosis of periodontitis. This trend is often more severe in patients with DM, COPD, or CKD, but this association with underlying diseases is only applicable when considering the association between periodontitis and fungal sinusitis. View on Web

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Characterization of FA1654: a putative DPS protein in Filifactor alocis

alexandrossfakianakis shared this article with you from Inoreader Characterization of FA1654: a putative DPS protein in Filifactor alocis via Molecular Oral Microbiology Abstract The survival/adaptation of Fillifactor alocis, a fastidious gram positive asaccharolytic anaerobe, to the inflammatory environment of the periodontal pocket requires an ability to overcome oxidative stress. Moreover, its pathogenic characteristics are highlighted by its capacity to survive in the oxidative-stress microenvironment of the periodontal pocket and a likely ability to modulate the microbial community dynamics. There is still a significant gap in our understanding of its mechanism of oxidative stress resistance and its impact on the virulence and pathogenicity of the microbial biofilm. Coinfection of epithelial cells with F.alocis and P.gingivalis, resulted in the upregulation of several genes including HMPREF0389_01654(FA1654). Bioinformatics analysis indicates that FA1654 has a "di-iron binding domain", and could function as a DNA Starvation and Stationary Phase Protection (DPS) protein. We have further characterized the FA1654 protein to deter mine its role in oxidative stress resistance in F.alocis. In the presence of hydrogen peroxide induced oxidative stress there was a ∼1.3 fold upregulation of the FA1654 gene in F.alocis. Incubation of the purified FA1654 protein with DNA in the presence of hydrogen peroxide and iron resulted in the protection of the DNA from Fenton-mediated degradation. Circular Dichroism (CD) and Differential Scanning Flourimetry (DSF) studies have documented the intrinsic ability of rFA1654 protein to bind iron, however the rFA1654 protein is missing the intrinsic ability to reduce hydrogen peroxide. Collectively, the data may suggest that FA1654 in F.alocis is involved in oxidative stress resistance via an ability to protect against Fenton-mediated oxidative stress-induced damage. This article is protected by copyright. All rights reserved View on Web

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Role of Natural mTOR Inhibitors in Treatment of Diabetes Mellitus

alexandrossfakianakis shared this article with you from Inoreader Role of Natural mTOR Inhibitors in Treatment of Diabetes Mellitus via Fundamental & Clinical Pharmacology Abstract Diabetes mellitus is one of the most common and complex problems in today's society and is responsible for many socio-economic problems. Type 1 diabetes is due to a defect in insulin secretion caused by a destruction of pancreatic β cells. In contrast, the pathogenesis of type 2 diabetes is associated with the development of insulin resistance in the liver and peripheral tissues, a decrease in β-cell mass, and a defect in insulin secretion. Various factors such as inflammation, stress, obesity, and lifestyle are involved in diabetes. Long-term or chronic increase in glucose in these patients is the leading causes of secondary disorders such as micro- and macro-angiopathy, weakness of the antioxidant defense system as well as metabolic disorders and altered lipid profile. The above conditions lead to short-term and long-term complications. These complications cause damage to the physical and physiological function of diverse orga ns of the body and threaten human health. Late complications of diabetes, including nephropathy, retinopathy, cardiovascular complications, neuropathy, hypertension, and weight gain are common and more research has been done on them. Numerous drugs such as Meglitinides, Biguanides, and Thiazolidinedione have been proposed to reduce high blood sugar, but due to the lack of complete cure of this disease with the use of existing drugs, the tendency to use alternative and traditional therapies has increased. In the meantime, the role of herbs with hypoglycemic properties in the treatment of diabetic patients cannot be ignored. The consumption of herbs by people with diabetes has become widespread even in Western countries. The use of herbs could be considered when conventional therapies cannot control the disease, and the patient needs to be prescribed insulin. The mammalian target of rapamycin, mTOR, plays a significant role in regulating cell growth, cellular metabolic status in respo nse to nutrients, many extracellular cues and growth factors. Impaired insulin secretion can lead to altered mTOR signaling. The mTOR pathway has shown different behaviors depending on the situation. It has been shown that mTOR can regulate the adaptation of β cells to blood sugar but also chronic inhibition of the mTOR pathway can also induce diabetes. Here, we have reviewed recent findings on the role of mTOR in major metabolic organs, such as the liver, pancreas, brain, and adipose tissue and muscle, and discussed its potential as a diabetes-related drug target. View on Web

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An HPV-Vaccinated Patient With Human Papillomavirus-Positive Oropharyngeal Squamous Cell Carcinoma

alexandrossfakianakis shared this article with you from Inoreader An HPV-Vaccinated Patient With Human Papillomavirus-Positive Oropharyngeal Squamous Cell Carcinoma via JAMA Otolaryngology–Head & Neck Surgery Online First This case report describes an extremely early-onset case of hu man papillomavirus–positive oropharyngeal squamous cell carcinoma in a Norwegian woman in her early 20s. View on Web

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Use of the Toxicity Index in Evaluating Adverse Events in Anal Cancer Trials: Analysis of RTOG 9811 and RTOG 0529

alexandrossfakianakis shared this article with you from Inoreader Use of the Toxicity Index in Evaluating Adverse Events in Anal Cancer Trials: Analysis of RTOG 9811 and RTOG 0529 via American Journal of Clinical Oncology - Current Issue Novel toxicity metrics that account for all adverse event (AE) grades and the frequency of may enhance toxicity reporting in clinical trials. The Toxicity Index (TI) accounts for all AE grades and frequencies for categories of interest. We evaluate the feasibility of using the TI methodology in 2 prospective anal cancer trials and to evaluate whether more conformal radiation (using Intensity Modulated Radiation Therapy) results in improved toxicity as measured by the TI. Patients enrolled on NRG/RTOG 0529 or nonconformal RT enrolled on the 5-Fluorouracil/Mitomycin arm of NRG/RTOG 9811 were compared using the TI. Patients treated on NRG/RTOG 0529 had lower median TI compared with patients treated with nonconformal RT on NRG/RTOG 9811 for combined GI/GU/Heme/Derm events (3.935 vs 3.996, P=0.014). The TI methodology is a feasible method to assess all AEs of interest and may be useful as a composite metric for future efforts aimed at treatment de-escalation or escalation View on Web

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A Parallel Line of Inquiry Related to Inferior Turbinate Hypertrophy and Extraesophageal Reflux

alexandrossfakianakis shared this article with you from Inoreader A Parallel Line of Inquiry Related to Inferior Turbinate Hypertrophy and Extraesophageal Reflux via JAMA Otolaryngology–Head & Neck Surgery Online First To the Editor Zeleník and colleagues have reported a possible association between inferior turbinate hypertrophy and extraesophageal reflux (EER). They also highlight previously reported associations of EER with chronic rhinosinusitis and chronic otitis media. View on Web

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Predicting Factors for a Favorable Pathologic Response to Neoadjuvant Therapy in Esophageal Cancer

alexandrossfakianakis shared this article with you from Inoreader Predicting Factors for a Favorable Pathologic Response to Neoadjuvant Therapy in Esophageal Cancer via American Journal of Clinical Oncology - Current Issue Background: Favorable pathologic response(FPR) is a significant predictor for improved survival following Neoadjuvant therapy(NAT) in esophageal and gastroesophageal cancer(GEJ). Preoperative prediction of FPR could modify treatment plans. No reliable method for predicting FPR exists. We sought to identify preoperative predicting factors for FPR. Materials and Methods: Retrospective analysis of patients with esophageal and GEJ cancer who underwent esophagectomy following (NAT). Univariate and multivariate analysis was used to identify preoperative predicting factors for FPR. A comparison of Tumor Regression Grade(TRG) was used to assess treatment response on overall survival(OS). Results: Out of 121 patients, 82(67.8%) had neoadjuvant chemoradiation. FPR was observed in 60(49.6%). Female sex, Radiation therapy(RT), squamous cell carcinoma(SCC), lack of signet ring feature, and FDG avidity posttreatment were associated with FPR on univariate analysis. RT and SCC were associated with FPR (OR=3.9 and 4.0, respectively) on multivariate analysis. OS was lower among patients who did not achieve FPR to NAT(P=0.027). Conclusions: FPR is a predictor of improved OS. SCC and radiation therapy-based protocol were identified as major prediction factors of FPR in patients with esophageal and GEJ cancers. View on Web

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Diagnosis and management of bile leaks after severe liver injury: A Trauma Association of Canada multicenter study

alexandrossfakianakis shared this article with you from Inoreader Diagnosis and management of bile leaks after severe liver injury: A Trauma Association of Canada multicenter study via Journal of Trauma and Acute Care Surgery - Current Issue BACKGROUND Optimal management of bile leaks (BLs) after severe liver injury is unknown. Study objectives were to define current practices in diagnosis and management of BL to determine which patients may benefit from endoscopic retrograde cholangiopancreatography (ERCP). METHODS American Association for the Surgery of Trauma grade ≥III liver injuries from 10 North American trauma centers were included in this retrospective study (February 2011 to January 2021). Groups were defined as patients who developed BL versus those who did not. Subgroup analysis of BL patients was performed by management strategy. Bivariate analysis compared demographics, clinical/injury data, and outcomes. Receiver operating characteristic curves were performed to investigate the relationship between bilious drain output and ERCP. RESULTS A total of 2,225 patients with severe liver injury met the study criteria, with 108 BLs (5%). Bile leak patients had higher American Association for the Surgery of Trauma grade of liver injury (p 300 to 400 mL were most likely to undergo ERCP, percutaneous transhepatic biliary drain, or surgical management. Once external drainage of BL has been established, we recommend ERCP be reserved for patients with BL >300 mL of daily output. Prospective multicenter examination will be required to validate these retrospective data. LEVEL OF EVIDENCE Therapeutic and Care Management; Level IV. View on Web

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