Nevin Manimala

Dent Med Probl. 2025 Jul-Aug;62(4):751-757. doi: 10.17219/dmp/177932.

ABSTRACT

Gingivitis is defined as the inflammation of the gums. The condition may spread to other parts of the periodontium, including the periodontal ligament and alveolar bone, and lead to bony defects. Melatonin has a positive impact on the bone healing process, a phenomenon attributable to its antioxidant properties, as well as its capacity to regulate bone cells and promote angiogenesis. The present meta-analysis aimed to evaluate the effect of melatonin as an adjunct to non-surgical periodontal therapy (NSPT) in the treatment of periodontitis. A thorough electronic search of the PubMed®/MEDLINE and Google Scholar databases was conducted, in addition to a manual search of the reference lists of archived articles published until May 2023. Among the 8 reviewed articles, 3 studies that evaluated probing depth (PD) and had a 6-month follow-up period were considered for the meta-analysis. After extracting the relevant information, the risk of bias was estimated. A summary of the estimates for standardized mean differences (SMDs) from fixed-effects and random-effects models was obtained based on the mean treatment differences reported in the selected studies. The results demonstrated the overall estimated effect from the fixed-effects model (SMD = 0.862, 95% confidence interval (95% CI): 0.517-1.207, p < 0.001) and the random-effects model (SMD = 0.869, 95% CI: 0.499-1.238, p < 0.001), with minimal inconsistency as indicated by the Q statistic and I2, respectively. Thus, it can be concluded that melatonin may be used as an adjunctive medication with NSPT for the management of periodontitis.

PMID:40899377 | DOI:10.17219/dmp/177932

Catheter Cardiovasc Interv. 2025 Sep 3. doi: 10.1002/ccd.70133. Online ahead of print.

ABSTRACT

BACKGROUND: Carotid artery stenosis is a significant risk factor for ischemic stroke. Two primary interventions, carotid artery stenting (CAS) and carotid endarterectomy (CEA), are commonly used to prevent stroke.

AIMS: This study systematically reviews and compares the efficacy and safety of CAS versus CEA in preventing stroke and other related outcomes.

METHODS: A comprehensive search of medical databases such as MEDLINE, Web of Science, ScienceDirect, and Cochrane CENTRAL identified relevant studies comparing CAS and CEA. Meta-analyses were conducted using a random-effects model to pool risk ratios (RRs) with 95% confidence interval (CI). Heterogeneity was assessed using I-squared statistic and publication bias were assessed using Egger’s test and funnel plot.

RESULTS: CAS was associated with a significantly higher risk of stroke (RR = 1.490, 95% CI: 1.282-1.731, p < 0.001) and a borderline higher risk of restenosis (RR = 1.257, 95% CI: 1.000-1.578, p = 0.050) compared to CEA. However, CAS had a significantly lower risk of myocardial infarction (RR = 0.476, 95% CI: 0.341-0.664, p < 0.001) and cranial nerve palsy (RR = 0.079, 95% CI: 0.042-0.149, p < 0.001). No significant differences were found in all-cause mortality, TIA, or pulmonary embolus between CAS and CEA.

CONCLUSION: While CAS reduces the risk of myocardial infarction and cranial nerve palsy, it is associated with a higher risk of stroke and restenosis compared to CEA. These findings highlight the importance of individualized treatment decisions based on patient risk profiles.

PMID:40899356 | DOI:10.1002/ccd.70133

Surg Laparosc Endosc Percutan Tech. 2025 Sep 3. doi: 10.1097/SLE.0000000000001404. Online ahead of print.

ABSTRACT

BACKGROUND: Corrosive ingestion frequently leads to upper aerodigestive tract strictures, with the optimal surgical approach debated. This study investigates the safety and effectiveness of colonic interposition for this condition.

METHODS: We retrospectively reviewed 21 patients with corrosive-induced esophageal stricture who underwent left colonic interposition between 2017 and 2024. Procedures involved cervical dissection, colonic mobilization, retrosternal tunnel creation, and reconstruction. Four patients underwent fully open surgical procedures, and 17 patients underwent laparoscopic colon mobilization and retrosternal tunnel creation. Outcomes included surgical complications and short-term and long-term feeding function.

RESULTS: The mean age was 37 years, with a male predominance (14/21 patients). All had esophageal stricture secondary to chemical burn for >1 year, and 14 were malnourished. Stricture locations were cervical (5 patients), upper third (8 patients), middle third (8 patients), and lower third (3 patients). Laparoscopic surgery had longer mean operative times than open surgery (361 vs. 294 min). One patient developed gastric outlet obstruction due to an undiagnosed pyloric stenosis. All patients resumed oral feeding by postoperative day 2, and feeding jejunostomy were removed at 1 month. During a median 30-month follow-up, all maintained normal oral intake and survived.

CONCLUSIONS: Left colonic graft interposition for esophageal reconstruction in caustic strictures is safe and effective. However, the technique is complex, particularly laparoscopically. Adequate graft length, vascularity, and isoperistaltic anastomosis are crucial for success.

PMID:40899331 | DOI:10.1097/SLE.0000000000001404

High Alt Med Biol. 2025 Sep 3. doi: 10.1177/15578682251375921. Online ahead of print.

ABSTRACT

Liu, Zhen, Chao Nie, Lijia Yuan, Hui Jiang, Chuanchuan Liu, Yi Zhang, and Minghua Liu.Impact of Acute High-Altitude Exposure on the Timing of Tranexamic Acid Administration in Rabbits with Traumatic Hemorrhagic Shock. High Alt Med Biol. 00:00-00, 2025. Background: Acute exposure to high altitude (≤3 days)-induced physiological changes may shorten the therapeutic time window for tranexamic acid (TXA) administration after traumatic hemorrhagic shock (THS). This study aims to compare the differences in the TXA therapeutic time window between THS patients with acute high-altitude exposure and those in low-altitude regions. Methods: Forty-two anesthetized rabbits were divided into three groups: low-altitude THS (l-THS), high-altitude sham, and high-altitude THS. All h-THS groups were housed for 3 days in 10% oxygen chambers (simulating 5,000 m altitude) before experimentation. THS models were established by reducing mean arterial pressure from 105 to 55 mmHg through blood loss combined with left tibiofibular fracture. Animals received single-dose TXA (90 mg/kg) with the following subgroups: l-THS-2h and l-THS-3h (TXA administered 2 hours/3 hours post-THS), h-THS-1h, h-THS-2h, h-THS-3h and h-THS-4h (TXA administered 1 hours/2 hours/3 hours/4 hours post-THS). Comparative analyses included hemodynamic parameters, complete blood counts, coagulation-fibrinolysis function, endothelial injury markers, inflammatory cytokines, and pulmonary histopathological changes. Results: High-altitude exposure required less blood loss to achieve THS compared with low-altitude conditions (51.00 ± 2.45 ml vs. 59.60 ± 3.65 ml, p < 0.05). At 6 hours post-THS, compared to the l-THS-2h group [TIC risk (INR:1.34 ± 0.09), anaerobic oxidation levels, inflammatory response levels, and lung injury score (1.8 (1.0, 2.0))], the l-THS-3h group [INR:1.51 ± 0.08; 2.6 (2.0, 3.0)], h-THS-2h group [1.45 ± 0.06; 2.8 (2.0, 3.5)], h-THS-3h group [INR:1.75 ± 0.11; 5.6 (4.5, 6.5)], and h-THS-4h group [INR:1.99 ± 0.06; 6.2 (6.0, 6.5)] all showed significantly higher values. For the same observational indicators, compared with the l-THS-3h group, the h-THS-1h group had lower values, while the h-THS-3h and h-THS-4h groups showed higher values. No statistically significant differences were observed between the l-THS-2h and h-THS-1h groups, or between the l-THS-3h and h-THS-2h groups for all parameters. Conclusion: The optimal time window for TXA administration in traumatic hemorrhagic shock may be shorter at high altitude compared with low-altitude area. These findings could influence therapeutic guidelines for TXA administration at high altitudes in humans.

PMID:40899326 | DOI:10.1177/15578682251375921

J Endourol. 2025 Sep 3. doi: 10.1177/08927790251374291. Online ahead of print.

ABSTRACT

Objectives: To clarify disease behavior and oncological outcomes as well as the need for ureteroscopy (URS) implementation in patients with clinically suspected upper tract carcinoma in situ (UT-CIS). Patients and Methods: In this multi-institutional study, we retrospectively analyzed patients who met three criteria for clinically suspected UT-CIS between 2008 and 2018: positive high-grade cytology from the upper tract, absence of a solid upper tract lesion on imaging, and negative bladder biopsy. Patients who underwent URS were compared with those who did not. Kaplan-Meier curve was used to assess the natural history of treated UT-CIS and the prognostic impact of URS. Results: In total, 48 patients with clinically suspected UT-CIS were analyzed, of whom 27 (57%) had a previous history of urothelial carcinoma. Of 28 (58%) patients who underwent URS, pathologically confirmed UT-CIS and UT-non-CIS were detected in 7 (25%) and 6 (21%), respectively. As initial treatment, 23 (48%) patients received upper tract bacillus Calmette-Guérin, while 21 (44%) underwent radical nephroureterectomy (RNU). During a median follow-up of 44.8 months, the most common site that suffered recurrence and progression was the bladder (40% and 17%), followed by the affected (15% and 6%) and contralateral (8% and 4%) upper tract, respectively. Three-year overall, cancer-specific, upper tract-specific, progression-free (PFS), and recurrence-free survival estimates were 88.2%, 94.8%, 100%, 80.8%, and 52.4%, respectively. Survival outcomes were comparable regardless of URS implementation, with the exception of PFS. However, URS implementation resulted in an earlier transition to surgical intervention in 11% and avoided unnecessary RNU in 11%. Conclusions: UT-CIS is a pan-urothelial disease and frequently shows metachronous recurrence and progression in any part of the urinary tract, necessitating long-term, meticulous follow-up. Despite the lack of a statistical difference between patients with and without URS, we found that a non-negligible number of patients benefited from URS implementation.

PMID:40899324 | DOI:10.1177/08927790251374291

J Endourol. 2025 Sep 3. doi: 10.1177/08927790251372581. Online ahead of print.

ABSTRACT

Background and Objectives: Percutaneous nephrolithotomy (PCNL) technique trends have shifted toward smaller caliber access sheaths, leading to a varied array of miniPCNL (mPCNL) systems. Urinary biomarkers have been validated as noninvasive direct markers of renal cellular injury. Our objective was to assess changes in biomarkers levels in the perioperative setting, comparing mPCNL suction (s-mPCNL), non-suction (ns-mPCNL), and standard PCNL (sPCNL) systems. Patients and Methods: PCNL systems used were as follows: s-mPCNL single-step dilator (ClearPetra™, 18F), ns-mPCNL metallic dilator and sheath (Storz MIP-M, 17.5F), and sPCNL with balloon dilation (Nephromax, 24F). Urine samples were collected at three time points: preoperatively (V1), 1 hour postoperatively (V2), and 10 days postoperatively (V3). Samples were analyzed using enzyme-linked immunofluorescent assay for key biomarkers-kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and β2-microglobulin (β2M)-normalized to urine creatinine. The primary outcome was changes in urinary biomarkers. Results: Twenty patients were randomized into two groups: s-mPCNL and ns-mPCNL, and 10 patients were assigned to the sPCNL cohort. The mean differences and percent change in biomarker levels at different time intervals were calculated as follows: early injury (V1-V2), recovery (V2-V3), and long-term injury (V1-V3). There was a statistically significant rise in NGAL levels for both ns-mPCNL and s-mPCNL in the early injury interval (2.377; p = 0.004, 2.606; p < 0.001, respectively), and a subsequent fall in levels during the recovery interval for sPCNL, ns-mPCNL, and s-mPCNL (-4.720; p = 0.026, -2.427; p = 0.014, -3.141; p = 0.018, respectively). There was no statistically significant difference in all three biomarkers for all forms of PCNL in the long-term injury interval. Conclusion: There is a sharp rise in urinary biomarkers in the immediate postoperative setting, likely because of early tubular injury, more notable in ns-mPCNL systems that utilize metal sheaths. However, this is a transient effect that normalizes days later irrespective of the sheath size used during the PCNL.

PMID:40899321 | DOI:10.1177/08927790251372581

Stomatologiia (Mosk). 2025;104(4):88-92. doi: 10.17116/stomat202510404188.

ABSTRACT

OBJECTIVE: To assess the dental status of pediatric population in Kursk and Zheleznogorsk district and correlation with the functional area of residence.

MATERIAL AND METHODS: The study involved 425 patients from 6 to 15 years old, living in regions of different radius from the Mikhailovsky Mining and Processing Plant: proximity of residence 10-30 km (n₁ – group 1); 31-50 km (n₂ – group 2); more than 50 km – comparison group (n₃). Age subgroups were identified within the groups: children with early mixed bite aged 6-8 years (n₁=45, n₂=41, n₃=46), children with late mixed bite aged 9-12 years (n₁=48, n₂=46, n³=50), children with permanent bite aged 13-15 years (n₁=50, n₂=48, n₃=51).

RESULTS: The prevalence of caries among children is high (n₂ – 89.73%; n₃ – 89.12%). In the industrial risk zone, this indicator reaches 90.24%. For children of 6-8 years, there was a significant increase in the intensity of the carious process within the designated living areas: DMFT+df n₁=5.6 [5.4-5.8] (p<0.001) and n₂=5.4 [5.0-5.6] (p=0.0016) exceeds the median value of the comparison group 5.0 [4.7-5.1]. The level of caries resistance was also reduced with 95% probability for patients of Zheleznogorsk district: n₁ – 6.1 [5.8; 6.3] (p=0.0014) and n₂ – 5.9 [5.4;6.1] (p<0.001).There were no statistically significant differences in children of secondary school age and adolescence with the control group, but a negative trend was identified.

CONCLUSION: The results obtained demonstrate changes in the dental status of children living near an industrially active area, which is a prerequisite for careful monitoring of their health status.

PMID:40899298 | DOI:10.17116/stomat202510404188

Stomatologiia (Mosk). 2025;104(4):83-87. doi: 10.17116/stomat202510404183.

ABSTRACT

OBJECTIVE: To compare the results of surface electromyography in patients with functional disorders of the masticatory muscles at all stages of complex therapy and to demonstrate the need for the introduction of a generally accepted comprehensive approach to the examination and treatment of patients with this pathology.

MATERIAL AND METHODS: EMG studies were conducted in 127 patients of both sexes aged 35 to 54 years, who were divided into 2 groups. The first (control group) consisted of 20 patients without signs of functional disorders in the masticatory muscles. The second (main) group included 107 patients of both sexes with functional disorders in the masticatory muscles. The examination was carried out using a portable electromyograph “Synapsis” (Neurotech), adapted for dental purposes.

RESULTS: The application of surface electromyography in patients with functional disorders of the masticatory muscles revealed statistically significant differences in the values of the compared indices. EMG allowed for a visual assessment of the work of the masticatory musculature based on the results of qualitative and quantitative indicators of the bioelectrical activity of the masticatory muscles.

CONCLUSION: Performing surface EMG at all stages of rehabilitation is of undeniable value as the most accessible and informative method for diagnosing neuromuscular disorders in patients with increased tooth wear and masticatory muscle dysfunction, which improves the quality of orthopedic treatment.

PMID:40899297 | DOI:10.17116/stomat202510404183

Stomatologiia (Mosk). 2025;104(4):62-65. doi: 10.17116/stomat202510404162.

ABSTRACT

OBJECTIVE: To study the frequency of visits to dental surgeons in different subjects of the Russian Federation.

MATERIAL AND METHODS: The work used the data of sectoral statistical observation for 2017-2023 presented in the statistical compilations of the Ministry of Health of Russia on resource provision in federal districts and subjects of the Russian Federation for 2018, 2020, 2022 and 2024. Statistical and analytical methods of research were used in the work.

RESULTS: It was found that the highest attendance rate of dental surgeons nationwide was recorded in 2018 and 2019. During the COVID-19 pandemic period from 2019 to 2021, specialist attendance decreased by 10.5%. However, despite the imposed restrictive measures during the COVID-19 pandemic the number of visits to dental surgeons for the disease increased in 17.6% of the subjects of the Russian Federation. After the COVID-19 pandemic (from 2022 to 2023) the rate in general increased by 0.5%. In the period under study, the dynamics of attendance of dental surgeons in the country as a whole remains negative with a decrease of 9.9%.

CONCLUSION: The increase in the frequency of visits to dental surgeons among the population of the Russian Federation both during the COVID-19 pandemic and after it indicates an increase in the medical activity of the population in maintaining dental health.

PMID:40899294 | DOI:10.17116/stomat202510404162

Stomatologiia (Mosk). 2025;104(4):22-25. doi: 10.17116/stomat202510404122.

ABSTRACT

OBJECTIVE: Evaluation of the effectiveness of treatment of chronic generalized periodontitis by PDT method based on PCR diagnostic data.

MATERIAL AND METHODS: A clinical and laboratory study and treatment of chronic generalized periodontitis of moderate severity was conducted in 30 people (16 men and 14 women) aged 35 to 55 years without somatic pathology with orthognathic bite diagnosed according to ICD-10 K05.3. Complex treatment consisted of oral sanitation, removal of dental plaque and curettage of periodontal pockets followed by photodynamic therapy (4 sessions of 10 minutes each). Bacteriological examination was performed before and after PDT. The test material was collected from inflammation sites in the gingival sulcus area and from periodontal pocket areas. DNA determination of Prevotella intermedia, Tannerella forsythia (Bacteroides forsythus), Treponema denticola, Aggregatibacter actinomycetemcomitans (Actinobacillus actinomycetemcomitans) and Porphyromonas gingivalis was performed using the reagent kit Multident-5 by the method of accelerated sample preparation using reagents manufactured by Genlab LLC in accordance with the manufacturer’s instructions. The results were assessed by a semi-quantitative method (in points from 0 to 4).

RESULTS: According to PCR diagnostics, a positive trend was observed in patients after PDT treatment. The decrease in the frequency of A. actinomycetemcomitans DNA detection after treatment was not statistically significant. At the same time, A. actinomycetemcomitans was identified in 17 (85%), after therapy in 15 (80%) indivisuals. The frequency of P. intermedia detection after therapy decreased from 15 (40%) to 0 (0%) cases. The frequency of P. gingivalis DNA detection decreased by 1.4 times: from 18 (90%) cases before treatment to 13 (65%) after treatment. One month after PDT, the frequency of P. gingivalis DNA detection decreased by 2 times, and after 3 months by 1.4 times. T. forsythia was detected before treatment in all patients, after treatment in 18 cases (90%). One month after PDT, it decreased significantly and was completely eliminated, which remained the case after 3 months. T. denticola was detected in 16 (80%) patients before treatment and in 14 (70%) people after treatment.

CONCLUSIONS: PDT resulted in a significant reduction in the bacterial load in patients with moderate chronic generalized periodontitis.

PMID:40899287 | DOI:10.17116/stomat202510404122