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Κυριακή 29 Ιανουαρίου 2023

Prevention of peri‐implant disease in edentulous patients with fixed implant rehabilitations

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Abstract

Objectives

To provide an overview about the current approaches to prevent peri-implant diseases in edentulous patients with complete-arch implant-supported prostheses, and to review the clinical applications of the latest digital technologies for implant prosthodontics.

Methods

A review of the guidelines to prevent peri-implant diseases in patient's receiving complete-arch implant-supported prostheses including facially driven treatment planning procedures using either conventional or digital methods, computer-aided implant planning procedures, and prosthodontic design variables including the optimal number and distribution of dental implants, implant to abutment connection type, implant or abutment level design, screw- or cement-retained alternatives, prostheses contours, and material selection is provided. Furthermore, an outline of the current therapeutic management approaches to address peri-implant diseases is reviewed.

Conclusions

Clinicians should understand and know different planning and design-related variables that can affect biological and mechanical complication rates of complete-arch implant-supported prostheses. Maintenance protocols are fundamental for minimizing biological and mechanical complications.

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Pathogen‐agnostic immune biomarkers that predict infection after solid organ transplantation

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Pathogen-agnostic immune biomarkers that predict infection after solid organ transplantation


Abstract

Solid organ transplant recipients (SOTRs) remain at high risk for infection throughout their post-transplant course. Dosing of immunosuppressive medications, strategies that prevent infection, and choice of empiric antimicrobial treatment could be optimized by a better understanding of an individual patient's risk for infectious complications. Diagnostic tests that qualitatively or quantitatively measure the function of the immune system and/or its response to infection may be useful for individualized management decisions. Numerous studies have identified an association between infectious outcomes after solid organ transplantation (SOT) and the results of a variety of non-pathogen-specific or "pathogen-agnostic" immune monitoring tests. These biomarkers include humoral immune markers, functional or quantitative assessments of cellular immunity, transcriptomic-based diagnostics, and replication of viruses within the human virome, which have been used to predict or diagnose a v ariety of different infectious diseases complicating SOT. In this narrative review, we discuss several host-derived immune biomarkers that show promise for either predicting or diagnosing infection among SOTRs. However, additional studies are needed to determine the optimal use of immune response testing. Whether immune biomarkers contribute added benefits to current standard clinical care has not yet been determined. Testing must be validated across a range of clinical scenarios, including surveillance to predict infection risk and diagnosis of active infection at various time points post transplant.

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Exposure Characterization of Wood Dust Particulate, Endotoxins, and (1–3)-β-d-Glucans, and Their Determinants in Mozambiquan Wood Processing Workers

alexandrossfakianakis shared this article with you from Inoreader
Abstract
Objectives
Dust generated from wood processing comprises a heterogeneous mixture of inorganic and organic particles, including wood fragments, microorganisms, endotoxins, (1–3)-β-d-glucans, and allergens. This study characterized exposure to wood dust and its determinants in the Mozambiquan wood processing industry.
Methods
A total of 124 personal inhalable samples, collected from a stratified random sample of 30 workers, were analysed for dust particulate, endotoxins, and (1–3)-β-d-glucans. Mixed-effects models were developed to investigate significant exposure determinants.
Results
The geometric mean (GM) inhalable dust particulate concentrations were 3.29 mg m−3, 98 endotoxin units (EU) m−3, and 123 ng m−3 for (1–3)-β-d-glucans. Significant predictors for higher particulate levels included machinery (GMR = 1.93), sawing (GMR = 2.80), carpentry (GMR = 2.77), or painting (GMR = 3.03) tasks. Lebombo-ironwood species was associated with higher dust particulate levels (GMR = 1.97). Determinants of endotoxin concentrations included working with dry wood and damp cleaning methods, which were associated with lower levels. Working in closed buildings (GMR = 3.10) and dry sweeping methods were associated with higher (1–3)-β-d-glucan concentrations (GMR = 1.99).
Conclusions
Work tasks in certain exposure groups (machinery, sawing, carpentry, painting), processing certain wood species (Lebombo-ironwood) and working in closed buildings were associated with higher exposures, whilst using dry wood and damp cleaning practices reduced exposure levels.
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Perio‐prosthodontic pontic site management, part I: Pontic designs and their current applications

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Objective

Emulating natural dentition with dental implant restorations is challenging, increasing its complexity when a pontic area must be restored. Many different methods have been described to solve this problem. The pontic designs which have been proposed have specific indications and may require additional treatments, including soft tissue augmentation procedures, to increase the possibility of an esthetically pleasing and biologically tolerable outcome. Proper conditioning of the soft tissues during the interim restoration stage and adequate communication with the laboratory are also critical factors to a successful outcome. This article describes the different approaches to restoring pontic sites with different degrees of complexity, their clinical indications, and limitations viewed from a perio-prosthodontic approach.

Clinical Considerations

Different clinical scenarios for pontic sites require different approaches. Missing hard and soft tissues can be replaced by surgical or prosthetic means. Understanding the clinical indications and implications of the different pontic designs allows the clinician to make good decisions when planning and treating patients that require replacement of pontic spaces leading to more successful outcomes.

Conclusions

Different pontic designs have specific indications as well as biologic and esthetic prognoses. Selection of a good design, proper modifications during the provisionalization stage, and adequate communication with the dental laboratory will lead to higher chances of esthetic and biological success.

Clinical Significance

The proper pontic design allows for esthetically pleasing pontic sites which emulate natural emergence from the soft tissues while promoting biological stability.

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Πέμπτη 26 Ιανουαρίου 2023

The association among insomnia symptom severity, comorbid symptoms, and suicidal ideation in two veteran cohorts meeting diagnostic criteria for insomnia disorder

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Abstract

Objective

Examine the association between insomnia symptom severity and suicidal ideation (SI), after adjusting for clinical comorbidity in veterans meeting diagnostic criteria for insomnia disorder.

Methods

Secondary data analyses of psychometrically validated baseline assessments of depression, posttraumatic stress disorder (PTSD), and anxiety symptoms from two online insomnia intervention randomized clinical trials (n = 232; n = 80) were conducted. Multiple linear regression was used to determine the association between insomnia symptom severity and SI, after controlling for clinical comorbidity and demographics.

Results

Insomnia symptom severity was significantly correlated with comorbid depression, PTSD, and anxiety symptoms in both cohorts and significantly correlated with SI in one. After controlling for demographics and clinical comorbidity, insomnia symptom severity was not significantly associated with SI in linear regression models.

Conclusion

Findings extend insomnia-suicide research by providing evidence that insomnia symptom severity may not confer a unique risk for SI above comorbid mental health symptoms in veterans meeting diagnostic criteria for insomnia disorder.

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Analgesic Effectiveness of Preoperative Ultrasound‐Guided Erector Spinae Plane Block versus Paravertebral Nerve Block for Breast Surgery: A Systematic Review and Meta Analysis of Four Randomized Controlled Trials

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Objective

Our meta-analysis aimed to compare the analgesic effectiveness of ultrasound-guided preoperative erector spinae plane block (ESPB) versus paravertebral nerve block (PVB) in breast surgery.

Methods

PubMed, EMBASE and the Cochrane Library were searched for randomized controlled trials (RCTs) between January 1, 1980 and April 31, 2021 . The primary endpoints were perioperative pain score, analgesic consumption and assessment of block procedure. The secondary endpoints were intraoperative haemodynamic response, duration of surgery, postoperative antiemetic consumption and adverse effects.

Results

Four RCTs comprised of a total of 310 patients were included in our meta-analysis. No significant differences in the perioperative pain score and analgesic consumption were observed between ESPB and PVB in the operating room, post-anaesthesia care unit (PACU) and ward (at 1, 16, 12, and 24 hour, and the morning of postoperative day 1 (POD1) (all P > 0.05). Similarly, no significant differences in the duration of block, time to first analgesic, haemodynamic response, duration of surgery, postoperative antiemetic consumption and adverse effects were observed (all P > 0.05). However, our meta-analysis revealed that ultrasound-guided preoperative ESPB significantly reduced the duration of procedure time and frequency of guidance interventions, as well as increasing the block success rate among residents (all P < 0.05).

Conclusions

Both ultrasound-guided preoperative ESPB and PVB showed comparable analgesic effects in patients undergoing breast surgery. However, with a significantly shorter procedure time and higher block success rate, our findings suggest that ESPB may be a simple alternative to PVB in breast surgery.

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Association between inflammatory bowel disease and periodontitis: A bidirectional 2‐Sample Mendelian randomization study

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Aim

This Mendelian randomization (MR) study was performed to explore the potential bidirectional causal association between inflammatory bowel disease (IBD) and periodontitis.

Materials and methods

We used genetic instruments from the genome-wide association study (GWAS) summary statistics of European descent for IBD (12,882 cases, 21,770 controls) to investigate the association with periodontitis (3,046 cases, 195,395 controls) and vice versa. The radial inverse-variance weighted (IVW) method was carried out to obtain the primary causal estimates, and the robustness of the results was assessed by a series of sensitivity analyses. Due to multiple testing, associations with P values < 0.008 were considered as statistically significant, and P values ≥ 0.008 and < 0.05 were considered as suggestively significant.

Results

In the primary causal estimates, IBD as a whole was associated with an increased risk of periodontitis (odds ratio [OR], 1.060; 95% confidence interval [CI], 1.017; 1.105; P = 0.006). Subtype analyses showed that ulcerative colitis (UC) was associated with periodontitis (OR, 1.074; 95% CI 1.029; 1.122; P=0.001), while Crohn's disease (CD) was not. Regarding the reverse direction, periodontitis showed a suggestive association with IBD as a whole (OR, 1.065; 95% CI 1.013; 1.119; P=0.014). Subtype analyses revealed that periodontitis was associated with CD (OR, 1.100; 95% CI 1.038; 1.167; P=0.001) but not UC. The final models after outlier removal showed no obvious pleiotropy, indicating that our primary analysis results were reliable.

Conclusions

The present MR study provides moderate evidence on the bidirectional causal relationship between IBD and periodontitis. The bidirectional increased risk found in our study was marginal and, possibly, of limited clinical relevance. More studies are needed to support the findings of our current study.

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Inhibition of PIKFYVE kinase interferes ESCRT pathway to suppress RNA virus replication

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Abstract

ESCRT (Endosomal sorting complex required for transport) is essential in the functional operation of endosomal transport in envelopment and budding of enveloped RNA viruses. However, in non-enveloped RNA viruses such as enteroviruses of the Picornaviridae family, the precise function of ESCRT pathway in viral replication remains elusive. Here, we initially evaluated that ESCRT pathway is important for viral replication upon EV71 (Enterovirus 71) infection. Furthermore, we discovered that YM201636, a specific inhibitor of PIKFYVE (Phosphoinositide kinase, FYVE finger containing) kinase, significantly suppressed EV71 replication and virus-induced inflammation in vitro and in vivo. Mechanistically, YM201636 inhibits PIKFYVE kinase to block ESCRT pathway and endosomal transport, leading to the disruption of viral entry and replication complex in subcellular components and ultimately repression of intracellular RNA virus replication and virus-induced inflammatory responses. Furt her studies found that YM201636 broadly represses the replication of other RNA viruses, including CVB3 (Coxsackievirus B3), PV1 (Poliovirus 1), E11 (Echovirus 11), ZIKV (Zika virus), and VSV (Vesicular stomatitis virus), rather than DNA viruses, including ADV3 (Adenovirus 3) and HBV (Hepatitis B virus). Our findings shed light on the mechanism underlying PIKFYVE-modulated ESCRT pathway involved in RNA virus replication, and also provide a prospective antiviral therapy during RNA viruses infections.

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Molecular characterization of rotavirus infections in children less than 5 years of age with acute gastroenteritis in Tehran, Iran, 2021 to 2022: Emergence of uncommon G9P[4] and G9P[8] rotavirus strains

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Abstract

The present study was conducted to monitor the genotypes of circulating species A rotavirus (RVA) in Iran and investigate genetic linkages between specific RVA VP7, VP4, VP6, and NSP4 segments. For this purpose, 48 RVA strains were detected during the 2021-2022 seasons. The two combinations of G9P[4] and G9P[8] RVA strains were predominant. However, several other combinations of RVA also were detected. Based on the distribution of I and E genotypes (46 strains) with respect to G and P, the most common strains were G9P[4]-I2-E2 (19.5%), G9P[4]-I2-E1 (6.5%), G9P[4]-I1-E1 (4.3%), G9P[8]-I1-E1 (19.5%), and G9P[8]-I2-E2 (10.9%), which were followed by several other combinations of G and P RVA strains with different pattern of I-E genotypes and also emerging, rare and uncommon strains. The present study described the continued circulation of G9 strains with the emergence of uncommon G9P[4] and G9P[8] reassortants with three and two different I-E genotypes, respect ively, which have not been reported previously in Iran. Our findings indicated that these uncommon strains exhibited a unique genotype pattern comprising a mixture of genogroup 1 and 2 genes and suggest the need for further analysis of rare, uncommon, and emerging strains of RVA at all 11 gene segments to determine intergenogroup and intragenotype reassortments.

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Prevalence of cervical human papillomavirus and the risk of anal co‐infection in kidney transplant recipients: Results from a Danish clinical study

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Abstract

Background

: Kidney transplant recipients (KTRs) have increased risk of human papillomavirus (HPV)-related cancers, including cervical and anal cancer. In this cross-sectional clinical study, we investigated the prevalence of cervical high-risk HPV (hrHPV) and low-risk (lrHPV), risk factors for cervical hrHPV infection, and the prevalence of cervical and anal hrHPV co-infection in KTRs and immunocompetent controls.

Methods

: During 2016–2017, we recruited 125 female KTRs and 125 female immunocompetent controls from one dermatology department (KTRs and controls) and five nephrology departments (KTRs) in Denmark. Liquid-based cervical and anal cytology samples were tested for HPV DNA using the INNO-LiPA test and participants answered a questionnaire on lifestyle. Odds ratios (ORs) were estimated using logistic regression, adjusting for age, lifetime sexual partners, smoking, and (in models concerning anal HPV) receptive anal sex.

Results

: KTRs had higher prevalence of cervical hrHPV than controls (35.5% vs 18.2; ORadjusted = 2.9, 95% CI, 1.5–5.5). In contrast, the prevalence of lrHPV was similar in KTRs and controls (25.6% vs 23.1; ORadjusted = 1.2, 95% CI, 0.7‒2.3). KTRs were more likely than controls to have cervical and anal hrHPV co-infection (27.3% vs. 6.6%, ORadjusted = 6.3, 95% CI, 2.7–15.0).

Conclusions

: Female KTRs had high prevalence of cervical hrHPV, and co-infection with anal and cervical hrHPV was common. Our results underline that KTRs are an important target group for preventive efforts against HPV-related diseases.

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