Nevin Manimala

Maxillofac Plast Reconstr Surg. 2024 Feb 28;46(1):6. doi: 10.1186/s40902-024-00419-8.

ABSTRACT

BACKGROUND: The size of dental implants is a key success factor for appropriate osseointegration. Using shorter implants allows the possibility of avoiding complex surgical procedures and reduces the morbidity of treatment. Shorter implants also enable implant-prosthetic rehabilitation after maxillofacial reconstructions where only limited bone is available. In this study, the success rates of short implants were examined and compared to those of standard-sized implants.

METHODS: Patients who received dental implants between 2007 and 2016 at the Department of Oro-Maxillofacial Surgery and Stomatology Semmelweis University were enrolled in the study. Several clinical parameters were recorded and supplemented with radiological examinations. The data were statistically analysed.

RESULTS: Thirty-four patients with a total of 60 implants were included. The average time after prosthetic loading was 39.33 ± 21.96 months in the group with 8-mm implants and 41.6 ± 27.5 months in the group with > 8-mm implants. No significant differences were observed between the two groups in terms of probing depth (short implants, 2.84 ± 0.09 mm; standard implants, 2.91 ± 0.35 mm) or mean marginal bone loss (short implants, 1.2 ± 1.21-mm mesially and 1.36 ± 1.47-mm distally; standard implants: 0.63 ± 0.80-mm mesially and 0.78 ± 0.70-mm distally).

CONCLUSIONS: In this study, the success rate of short dental implants was comparable to that of standard-sized implants. Consequently, it can be claimed that the long-term success of short dental implants does not differ significantly from the long-term success of standard implants.

PMID:38416263 | DOI:10.1186/s40902-024-00419-8

Gastric Cancer. 2024 Feb 28. doi: 10.1007/s10120-024-01477-7. Online ahead of print.

ABSTRACT

BACKGROUND: The relationship between high-density lipoprotein cholesterol (HDL-C) and gastroesophageal cancer is not constant.

METHODS: In this population-based cohort study, 4.518 million cancer-free individuals among those who underwent national cancer screening in 2010 were enrolled and followed up until December 2017. HDL-C level was classified into eight groups at 10 mg/dL intervals. The risk of gastroesophageal cancers by HDL-C was measured using adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs).

RESULTS: During 8 years of follow-up, 38,362 gastric and 3022 esophageal cancers developed. Low HDL-C level was associated with an increased risk of gastric cancer; aHR was 1.19 (95% CI 1.09-1.30) for HDL-C < 30 mg/dL, 1.07 (95% CI 1.03-1.12) for HDL-C of 30-39 mg/dL, and 1.07 (95% CI 1.03-1.12) for HDL-C of 40-49 mg/dL comparing to HDL-C of 60-69 mg/dL. HDL-C was positively associated with esophageal cancer risk; aHR was 1.30 (1.12-1.51) for HDL-C of 70-79 mg/dL, 1.84 (1.53-2.22) for HDL-C of 80-89 mg/dL, 2.10 (1.67-2.61) for HDL-C ≥ 90 mg/dL. These site-specific effects of HDL-C were robust in sensitivity analyses. The range of HDL-C for the lowest cancer risk was different by sex and site. The hazardous effect of low HDL-C on gastric cancer was prominent in never and past smokers, and extremely high HDL-C increased gastric cancer risk (aHR 1.19; 95% CI 1.04-1.36) only in current smokers. Unfavorable effect of high HDL-C on gastroesophageal cancer risk was remarkable in smokers.

CONCLUSIONS: Low HDL-C increased the risk of gastric cancer, wherein high HDL-C was associated with esophageal cancer risk with discrepancies by sex and smoking status.

PMID:38416240 | DOI:10.1007/s10120-024-01477-7

Graefes Arch Clin Exp Ophthalmol. 2024 Feb 28. doi: 10.1007/s00417-024-06421-0. Online ahead of print.

ABSTRACT

PURPOSE: To report short-term outcomes of treatment switch to faricimab in real-world patients with aflibercept-resistant neovascular age-related macular degeneration (AMD).

METHODS: Single-center, retrospective cohort study with chart-review using electronic injection database, electronic medical records, and optical coherence tomography (OCT) data from May to September 2023.

RESULTS: A total of 50 eyes of 46 patients were analyzed. Faricimab treatment led to absence of fluid in 32% of the eyes and a reduction of fluid in 84% of the eyes. There was a statistically significant decrease in central retinal thickness (CRT) and pigment epithelial detachment (PED) height in those that responded to the switch (median difference: – 31 μm, IQR: 55, p < 0.0001 and median difference: – 21 μm, IQR: 36, p < 0.0001, respectively) and a statistically significant increase in CRT (median difference: + 19 μm, IQR: 20, p = 0.0143) and no change in PED height (median difference: + 22 μm, IQR: 64, p = 0.1508) in those that did not. Best-corrected visual acuity (BCVA) showed marginal decrease with low statistical significance. No ocular or systemic safety events were observed.

CONCLUSIONS: Our findings suggest that switching to faricimab is generally safe and effective in patients with neovascular AMD who are otherwise difficult to treat and have residual fluid despite frequent injections with aflibercept. We observed a high rate of morphological response to the treatment switch, improvement of anatomical parameters with about one-third of patients having dry macula following a single injection, and a marginal change in BCVA. Sustainability of these results requires further investigation.

STUDY REGISTRATION: ClinicalTrials.gov registration number: NCT06124677. Date of registration: 09/11/2023, retrospectively registered.

PMID:38416237 | DOI:10.1007/s00417-024-06421-0

J Med Virol. 2024 Mar;96(3):e29468. doi: 10.1002/jmv.29468.

ABSTRACT

Cervical human papillomavirus (HPV) infection is believed to increase the risks of pregnancy failure and abortion, however, whether the uterine cavity HPV infection reduces pregnancy rate or increases miscarriage rate remains unclarified in infertile women undergoing assisted reproductive technology (ART) treatment. Therefore, we aimed to assess ART outcomes in the presence of intrauterine HPV. This was a hospital-based multicenter (five reproductive medicine centers) matched cohort study. This study involved 4153 infertile women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection treatment in five reproductive medicine centers between October 2018 and 2020. The spent embryo transfer media sample with endometrium tissue were collected and performed with flow-through hybridization and gene chips to detect HPV DNA. According to basic characteristics, HPV-positive and negative patients were matched in a ratio of 1:4 by age, body mass index transfer timing, transfer type, and number of embryos transferred. The primary outcome was pregnancy and clinical miscarriage rates in the transfer cycle underwent HPV detection. 92 HPV-positive and 368 HPV-negative patients were screened and analyzed statistically. Univariate analysis showed uterine cavity HPV infection resulted in lower rates of ongoing pregnancy (31.5% vs. 44.6%; p = 0.023), implantation (32.3% vs. 43.1%; p = 0.026), biochemical pregnancy (47.8% vs. 62.5%; p = 0.010), and clinical pregnancy (40.2% vs. 54.3%; p = 0.015) compared with HPV negative group. The infertile female with positive HPV also had a slightly higher frequency of biochemical miscarriage (15.9% vs. 13.0%; p = 0.610) and clinical miscarriage (24.3% vs. 15.5%; p = 0.188). These findings suggest that HPV infection in the uterine cavity is a high risk for ART failure. HPV screening is recommended before ART treatment, which may be benefit to improving pregnancy outcome.

PMID:38415499 | DOI:10.1002/jmv.29468

Curr Med Imaging. 2024 Feb 26. doi: 10.2174/0115734056290762240209071656. Online ahead of print.

ABSTRACT

INTRODUCTION: The diagnosis and characterization of vertebral compression fractures are very important for clinical management. In this evaluation, which is usually performed with diagnostic (conventional) imaging, the findings are not always typical or diagnostic. Therefore, it is important to have new information to support imaging findings. Texture analysis is a method that can evaluate information contained in diagnostic images and is not visually noticeable. This study aimed to evaluate the magnetic resonance images of cases diagnosed with vertebral compression fractures by the texture analysis method, compare them with histopathological data, and investigate the effectiveness of this method in the differentiation of benign and malignant vertebral compression fractures.

METHODS: Fifty-five patients with a total of 56 vertebral compression fractures were included in the study. Magnetic resonance images were examined and segmented using Local Image Feature Extraction (LIFEx) software, which is an open-source program for texture analysis. The results were compared with the histopathological diagnosis.

RESULTS: The application of the Decision Tree algorithm to the dataset yielded impressively accurate predictions (≈95% in accuracy, precision, and recall).

CONCLUSION: Interpreting tissue analysis parameters together with conventional magnetic resonance imaging findings can improve the abilities of radiologists, lead to accurate diagnoses, and prevent unnecessary invasive procedures. Further prospective trials in larger populations are needed to verify the role and performance of texture analysis in patients with vertebral compression fractures.

PMID:38415478 | DOI:10.2174/0115734056290762240209071656

Curr Med Imaging. 2024 Feb 27. doi: 10.2174/0115734056258544231115103528. Online ahead of print.

ABSTRACT

BACKGROUND: In the last few years, coronavirus disease 2019 (COVID-19) has changed human lifestyle, behavior, and perception of life. This disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). In the literature, there are limited studies about the late renal effects of COVID-19 that reflect the systemic involvement of this disease.

AIM: In the present study, we aimed to compare sonoelastographic changes in both kidneys between patients who had totally recovered from COVID-19 and healthy individuals using strain wave elastography (SWE).

METHODS: This study was conducted between June 2021 and May 2022 in Kahramanmaraş City Hospital Department of Radiology. File and archive records were retrospectively evaluated. Basic demographic, laboratory, and renal ultrasonography (USG) and sonoelastographic findings were screened and noted. Two groups were defined to compare sonoelastographic findings. Post-long COVID-19 group had 92 post-long COVID-19 patients, and the comparator group had 9 healthy individuals”. Both groups’ demographic, laboratory, and ultrasound-elastographic findings were assessed.

RESULTS: The post-long COVID-19 group had a higher renal elastographic value than the comparator group (1.52 [0.77-2.3] vs. 0.96 [0.54-1.54], p<0.001). There were no statistically significant differences between the two groups in terms of age (p=0.063), gender (p=0.654), or body mass index (BMI) (p=0.725), however, there was a significant difference observed between the two groups in the renal strain ratio (RSR). According to an ROC analysis, an RSR cutoff of >1.66 predicted post-long COVID-19 with 44.9% sensitivity and 81.9% specificity. (AUC=0.655, p<0.001). A separate ROC analysis was performed to predict post-long COVID-19 with a BMI cutoff of <33.52, kg/m2 sensitivity of 92.4% and specificity of 17% (AUC=0.655, p<0.001).

CONCLUSION: We demonstrated that renal parenchymal stiffness increases with SWE in post-long COVID-19 patients.

PMID:38415466 | DOI:10.2174/0115734056258544231115103528

Curr Med Imaging. 2024 Feb 27. doi: 10.2174/0115734056278130231218073650. Online ahead of print.

ABSTRACT

INTRODUCTION: A recently developed deep-learning-based automatic evaluation model provides reliable and efficient Cobb angle measurements for scoliosis diagnosis. However, few studies have explored its clinical application, and external validation is lacking. Therefore, this study aimed to explore the value of automated assessment models in clinical practice by comparing deep-learning models with manual measurement methods.

METHODS: The 481 spine radiographs from an open-source dataset were divided into training and validation sets, and 119 spine radiographs from a private dataset were used as the test set. The mean Cobb angle values assessed by three physicians in the hospital’s PACS system served as the reference standard. The results of Seg4Reg, VFLDN, and manual measurement were statistically analyzed. The intra-class correlation coefficients (ICC) and the Pearson correlation coefficient (PCC) were used to compare their reliability and correlation. The Bland-Altman method was used to compare their agreement. The Kappa statistic was used to compare the consistency of Cobb angles at different severity levels.

RESULTS: The mean Cobb angle values measured were 35.89° ± 9.33° with Seg4Reg, 31.54° ± 9.78° with VFLDN, and 32.23° ± 9.28° with manual measurement. The ICCs for the reliability of Seg4Reg and VFLDN were 0.809 and 0.974, respectively. The PCC and MAD between Seg4Reg and manual measurements were 0.731 (p<0.001) and 6.51°, while those between VFLDN and manual measurements were 0.952 (p<0.001) and 2.36°. The Kappa statistic indicated VFLDN (k= 0.686, p< 0.001) was superior to Seg4Reg and manual measurements for Cobb angle severity classification.

CONCLUSION: The deep-learning-based automatic scoliosis Cobb angle assessment model is feasible in clinical practice. Specifically, the keypoint-based VFLDN is more valuable in actual clinical work with higher accuracy, transparency, and interpretability.

PMID:38415463 | DOI:10.2174/0115734056278130231218073650

Curr Med Imaging. 2024 Feb 27. doi: 10.2174/0115734056269300231127052836. Online ahead of print.

ABSTRACT

AIM: To identify age-matched healthy volunteers, non-cirrhotic chronic liver disease (CLD) and cirrhotic patients based on portal hemodynamic parameters using 4D flow MRI.

METHODS: A total of 10 age-matched healthy volunteers and 69 CLD patients were enrolled and underwent 4D flow MRI prospectively. 4D flow MR images were processed by an MD in biomedical engineering working on the GTFlow platform. Portal hemodynamic parameters include net flow (mL/cycle), flow volume per second through the lumen (mL/sec), average flow velocity (cm/sec), and maximum flow velocity (cm/sec). The difference in portal hemodynamic parameters of 4D flow MRI was compared among healthy volunteers, non-cirrhotic CLD patients and patients with cirrhosis by one-way ANOVA or Kruskal-Wallis nonparametric test and post hoc tests.

RESULTS: 10 CLD patients without cirrhosis and 56 patients with cirrhosis were eventually included, along with 10 healthy volunteers who were divided into three groups. 3 patients with cirrhosis whose image quality did not meet the requirements were excluded. There were no significant differences in portal hemodynamic parameters among the three groups except portal average velocity (P > 0.05). There was no statistical difference in all portal hemodynamic parameters of 4D flow MRI between healthy volunteers and patients with cirrhosis (P > 0.05). There were significant differences in portal average velocity between non-cirrhotic CLD patients, healthy volunteers and patients with cirrhosis, respectively (11.44±3.93 vs 8.10±2.66, P=0.013; 11.44±3.93 vs 8.60±2.22, P=0.007).

CONCLUSION: Portal average velocity obtained by 4D flow MRI can be an auxiliary means to identify cirrhosis in patients with CLD.

PMID:38415457 | DOI:10.2174/0115734056269300231127052836

J Cosmet Dermatol. 2024 Feb 28. doi: 10.1111/jocd.16254. Online ahead of print.

ABSTRACT

BACKGROUND: The emulgel, a novel drug delivery system, merges emulsion and gel, offering advantages like enhanced stability, precise control over drug release kinetics, and increased drug absorption compared to emulsions alone. Kojic acid (KA) demonstrates potent inhibition of the tyrosinase enzyme, a crucial player in the melanin synthesis pathway.

AIMS: The main objective of this experimental study is to formulate KA within an emulgel framework and assess its stability under various environmental conditions.

METHODS: One percent of KA emulgel and 1% simple gel, serving as the control product, were supplemented with varying concentrations of sodium metabisulfite (SMBS) for its antioxidant properties. The formulations were segregated into four groups and subjected to diverse maintenance and stress conditions over a three-month period. Monthly evaluations of physicochemical alterations were conducted, initially employing digital photography, followed by the extraction of KA and subsequent quantification of its concentration through high performance liquid chromatography (HPLC).

RESULTS: The best formulations for retaining KA among the prepared ones were the 0.25% SMBS KA emulgel and the 0.1% SMBS KA simple gel, capable of retaining 86% and 76% of the initial KA content under stress conditions, respectively (p < 0.0001).

CONCLUSIONS: Regarding to this study, ideal storage condition for KA emulgel and simple gel is in the refrigerator temperatures. Moreover, optimal SMBS concentrations for stability enhancement are 0.25% for emulgel and 0.1% for the simple gel. A significant statistical difference was observed between refrigerated emulgel and simple gel in the retention of KA in the presence of optimum concentration of antioxidants (p < 0.0001).

PMID:38415395 | DOI:10.1111/jocd.16254

Dent Med Probl. 2024 Jan-Feb;61(1):77-83. doi: 10.17219/dmp/150655.

ABSTRACT

BACKGROUND: Platelet-rich fibrin (PRF) is widely used in periodontics for its wound healing potential. Two major variations of PRF are the original leukocyteand platelet-rich fibrin (L-PRF) and the modified lowspeed advanced PRF (A-PRF).

OBJECTIVES: The aim of the present study was to evaluate and compare the conventional L-PRF protocol and the low-speed A-PRF protocol in terms of angiogenic potential of PRF, using an in vivo chorioallantoic membrane (CAM) assay.

MATERIAL AND METHODS: Fifteen fertile Giriraja eggs were procured and after a 3-day incubation period, randomly allotted into 3 groups: control; L-PRF; and A-PRF. A total of 20 mL of blood was collected from systemically healthy male volunteers aged 18-24 years, using a standard protocol. The PRF samples were inoculated on the CAM of the eggs. On the 10th day, the eggs were reopened and photographed. The parameters assessed were the number, length, size, and density of blood vessels, as well as the number of junctions formed. The photographs were analyzed using the ImageJ and ProgRes® CapturePro software.

RESULTS: Seven days after inoculation, both the A-PRF and L-PRF groups exhibited significantly better results than the control group in terms of the number (59.20 ±6.61 vs. 48.80 ±5.07 vs. 19.20 ±6.98), length (25,000 ±1,813.10 μm vs. 17,000 ±282.90 μm vs. 8,000 ±184.49 μm), size (230,000 ±15,054.00 μm2 vs. 200,000 ±8,295.27 μm2 vs. 150,000 ±4,105.16 μm2), and density (central: 9,100 ±296.78 vs. 5,370 ±272.42 vs. 1,420 ±564.36; peripheral: 9,094 ±400.14 vs. 3,370 ±479.39 vs. 5,420 ±746.73) of blood vessels, as well as the number of junctions formed (52 ±3.81 vs. 41 ±1.58 vs. 33 ±4.64), respectively.

CONCLUSIONS: The angiogenic potential was increased by the exposure to both L-PRF and A-PRF. However, A-PRF demonstrated statistically significant benefits in terms of the number, length, size, and density of blood vessels, as well as the number of junctions formed in comparison with the control and L-PRF groups.

PMID:38415389 | DOI:10.17219/dmp/150655