Nevin Manimala

J Periodontol. 2023 Jul 12. doi: 10.1002/JPER.23-0285. Online ahead of print.

ABSTRACT

BACKGROUND: To investigate tooth-related factors that influence the reduction of pocket probing depths (PPD) after non-surgical periodontal therapy (NST).

MATERIALS AND METHODS: 746 patients with a total of 16825 teeth were included and retrospectively analyzed. PPD reduction after NST was correlated with the tooth-related factors; tooth type, number of roots, furcation involvement, vitality, mobility and type of restoration; using logistic multilevel regression for statistical analysis.

RESULTS: NST was able to reduce probing depth overall stratified probing depths (1.20±1.51mm p = <0.001). The reduction was significantly higher at teeth with higher probing depths at baseline. At pockets with PPD ≥ 6mm PPD remains high after NST. Tooth type, number of roots, furcation involvement, vitality, mobility and type of restoration are significantly and independently associated with the rate of pocket closure.

CONCLUSION: The tooth-related factors: tooth type, number of roots, furcation involvement, vitality, mobility and type of restoration had a significant and clinically relevant influence on phase I and II therapy. Considering these factors in advance may enhance the prediction of sites not responding adequately and the potential need for additional treatment, such as re-instrumentation or periodontal surgery, to ultimately achieve the therapy endpoints. This article is protected by copyright. All rights reserved.

PMID:37436696 | DOI:10.1002/JPER.23-0285

J Bone Miner Res. 2023 Jul 12. doi: 10.1002/jbmr.4880. Online ahead of print.

ABSTRACT

This study aims to evaluate the causal effect of sodium-glucose cotransporter 2 (SGLT2) inhibition on bone mineral density (BMD), osteoporosis, and fracture risk using genetics. Two-sample Mendelian randomization (MR) analyses were performed utilizing two sets of genetic variants as instruments (six and two single-nucleotide polymorphisms [SNPs]) associated with SLC5A2 gene expression and glycated hemoglobin A1c levels. Summary statistics of BMD from the Genetic Factors for Osteoporosis (GEFOS) consortium (BMD for total body, n = 66,628; femoral neck, n = 32,735; lumbar spine, n = 28,498; forearm, n = 8,143) and osteoporosis (6,303 cases, 325,717 controls) and 13 types of fracture (≤ 17,690 cases, ≤ 328,382 controls) data from the FinnGen study were obtained. One-sample MR and genetic association analyses were conducted in UK Biobank using the individual-level data of heel BMD (n = 256,286) and incident osteoporosis (13,677 cases, 430,262 controls) and fracture (25,806 cases, 407,081 controls). Using six SNPs as the instrument, genetically proxied SGLT2 inhibition showed little evidence of association with BMD of total body, femoral neck, lumbar spine, and forearm (all P ≥ 0.077). Similar results were observed using two SNPs as instruments. Little evidence was found for the SGLT2 inhibition effect on osteoporosis (all P ≥ 0.112) or any 11 major types of fracture (all P ≥ 0.094), except for a nominal significance for fracture of lower leg (P = 0.049) and shoulder and upper arm (P = 0.029). One-sample MR and genetic association analysis showed that both the weighted genetic risk scores constructed from the six and two SNPs were not causally associated with heel BMD, osteoporosis, and fracture (all P ≥ 0.387). Therefore, this study does not support an effect of genetically proxied SGLT2 inhibition on fracture risk. This article is protected by copyright. All rights reserved.

PMID:37436694 | DOI:10.1002/jbmr.4880

J Periodontol. 2023 Jul 12. doi: 10.1002/JPER.23-0161. Online ahead of print.

ABSTRACT

BACKGROUND: Evidence regarding the etiology behind bone loss around submerged, prosthetically non-loaded implants is still limited. The long-term stability and success of implants with early crestal bone loss (ECBL) especially when placed as two-stage implants, is uncertain. Hence, the aim of this retrospective study is to analyze the potential patient-level, tooth and implant related factors for ECBL around osseointegrated, submerged implants, prior to restoration as compared with healthy implants with no bone loss.

METHODS: Retrospective data was collected from patient electronic health records between 2015 and 2022. Control sites included healthy implants with no bone loss and test sites included implants with ECBL, both of which were submerged. Patient, tooth and implant level data was collected. ECBL was assessed using peri-apical radiographs obtained during implant placement and second-stage surgeries. Generalized estimating equation logistic regression models were used to account for multiple implants within patients.

RESULTS: The total number of implants included in the study was 200 from 120 patients. Lack of supportive periodontal therapy (SPT) was shown to have nearly five-times higher risk of developing ECBL and was statistically significant (p < 0.05). Guided bone regeneration (GBR) procedures prior to implant placement had a protective effect with an odds ratio of 0.29 (p < 0.05).

CONCLUSIONS: Lack of SPT was significantly associated with ECBL, while sites that received GBR procedures prior to implant placement were less likely to exhibit ECBL. Our results underscore the importance periodontal treatment and SPT for peri-implant health, even when the implants are submerged and unrestored. This article is protected by copyright. All rights reserved.

PMID:37436693 | DOI:10.1002/JPER.23-0161

Immunol Res. 2023 Jul 12. doi: 10.1007/s12026-023-09407-y. Online ahead of print.

ABSTRACT

An increasing number of breakthrough-COVID-19-vaccinated individuals are being reported across the world. Humoral immunity has a crucial role in combating infection. In this study, we aimed to assess the importance of anti-COVID-S1-IgA and anti-COVID-NP-IgA in confirmed COVID-19 after vaccination (breakthrough infection group). Blood samples were collected from the breakthrough infection group within one week of breakthrough infections (n = 34). A second sample was also collected after 4 to 8 weeks (n = 27). Blood samples of healthy individuals (n = 29) were collected 4-8 weeks after the completion of vaccination. Anti-COVID-S1-IgA and anti-COVID-NP-IgA were detected by ELISA. Statistical analysis was performed using IBM SPSS version 24. In this study, we found a higher positivity rate for anti-COVID-S1-IgA in the breakthrough infection group (70% vs. 28% in healthy individuals). Anti-COVID-NP-IgA was not found in the control group (11% in the breakthrough infection group vs. 0 in healthy individuals). In the breakthrough-infected group, the positivity rate of anti-COVID-NP-IgA decreased significantly (median titers 16.9 IU/ml decreased to 4.2 IU/ml) p = 0.001), while anti-COVID-S1-IgA increased over a period of 4-8 weeks (9.35-16.35 IU/ml). Importantly, IgA response to both COVID-19 NP and S1 antigens was not found in 13 patients at initial testing. The findings of this study show that serum IgA may have a role both in breakthrough infections and also in the prevention of severe infection. Sluggish anti-COVID-19-IgA antibody response may be responsible for the occurrence of COVID-19 infection in breakthrough infection. On the other hand, more sustained anti-COVID-19-S1-IgA over a longer period of time may have a role in preventing these patients from severe infections and hospitalization. However, a study on a larger sample size including patients with severe disease after vaccination is required to prove this hypothesis. To the best of our knowledge, this is the first study reporting the importance of serum IgA in breakthrough-infected patients from our region.

PMID:37436673 | DOI:10.1007/s12026-023-09407-y

Environ Monit Assess. 2023 Jul 12;195(8):937. doi: 10.1007/s10661-023-11543-9.

ABSTRACT

This study evaluated the characteristics of the water in Darbandikhan Lake and its rivers in the Kurdistan Region of Iraq. For this purpose, 25 samples were collected seasonally and analysed for 36 physiochemical parameters. The proportions of physiochemical parameters exceeding the WHO standards in the samples with their highest exceedances were 9894% for Al, 198% for Mn, 40% for Pb, 1.6% for pH, 3250% for PO₄, 11.8% for Sr, 155% for T.Alk, 7813% for turbidity, 1188% for Ti, 1033% for Tl and 1293% for V in the river water and 120% for Co, 74% for Cr, 4485% for Fe and 9% for K in the lake water. The pollution sources were designated by multivariate statistical analysis as being related to industrial and domestic waste, solid waste disposal, fertilisers and organic contamination from agricultural and natural sources. The water quality index (WQI) results were 22.3 to 721.3 for drinking, 13.9 to 86.2 for irrigation, 1.4 to 299.5 for livestock, 71.5 to 1754.4 for the textile industry, 20.7 to 237.9 for recreation and 64.6 to 1867.4 for aquatic life. The irrigation water quality index (IWQI) results were excellent for sodium adsorption ratio (SAR), and for the US salinity scale, all water samples fell into the medium salinity-low sodium category (C2-S1) in all seasons, except for all Chaqan River samples. The Tanjaro River sample in spring fell in the relatively high salinity-low sodium category (C3-S1), excellent and good for sodium percentage (Na%), suitable to moderate for permeability index (PI%), suitable to unsuitable for magnesium hazard percentage (MH%), suitable for Kelly Index (KI) and safe to unsuitable for residual sodium carbonates (RSC). The Sirwan River, Tanjaro River and Zmkan River took first to third place in both the annual average pollution share ratio and the discharge. While the Zalm River ranked fourth in discharge and fifth in pollution share ratio, the Chaqan River was the reverse. The highest pollution share ratio was 64.3 for the Sirwan River in summer, and the lowest was 0.7 for the Zalm River in autumn.

PMID:37436670 | DOI:10.1007/s10661-023-11543-9

J Relig Health. 2023 Jul 12. doi: 10.1007/s10943-023-01864-x. Online ahead of print.

ABSTRACT

This study examines the connection between health and religious beliefs in modern Chinese society and builds a model reimagining the conception of health. The study draws on interviews with 108 patients (52 were women and 56 were men) at Huashan Hospital (Shanghai City, China). The survey ran between May 10 and May 14, 2021. More than 50% of female and male respondents reported having religious beliefs. Most acknowledged the crucial role of faith and religious beliefs in overcoming treatment challenges and alleviating patient suffering. The role of faith and religious beliefs in physical/mental treatment and health maintenance received the highest average percent positive score among female respondents. According to the multiple regression results of demographic parameters (age, ethnicity, gender, education, and urban or rural residence), only gender had a statistically significant effect on the impact of religious beliefs on health care attitudes. The proposed model builds on the Confucian concept of Ren (humanity), which refers to a harmonious relationship between people within a family or society bound by specific rules. The results of this study can help expand awareness about religion and its role in healthcare as a means to support patients’ spiritual and physical health.

PMID:37436667 | DOI:10.1007/s10943-023-01864-x

J Adhes Dent. 2023 Jul 12;25(1):147-158. doi: 10.3290/j.jad.b4208859.

ABSTRACT

PURPOSE: This randomized controlled trial aimed to evaluate the 14-year clinical performance of a HEMA-free 1-step self-etch adhesive (1SEa) compared with that of a 3-step etch-and-rinse adhesive (3E&Ra).

MATERIALS AND METHODS: 267 non-carious cervical lesions in 52 patients were restored with the microhybrid composite Gradia Direct (GC), bonded in random order either with the HEMA-free 1SEa G-Bond (GB; GC) or the 3E&Ra Optibond FL (OFL; Kerr), which is considered the gold-standard E&Ra (control). The restorations were followed over 14 years for retention, marginal adaptation and discoloration, and caries occurrence. Statistical analysis involved a logistic regression model with generalized estimating equations (2-way GEE model).

RESULTS: The patient recall rate at 14 years was 63%. In total, 79 restorations (39 GB, 40 OFL) failed because of retention loss (GB: 19.4%, OFL: 19.6%), severe marginal defects, discoloration and/or caries (GB: 21.7%; OFL: 22.5%). The overall clinical success rate was 58.9% and 57.9% for GB and OFL, respectively. The number of restorations with an unacceptable marginal defect (GB: 14.5%; OFL: 19.2%) and deep marginal discoloration (GB: 18.2%; OFL: 13.2%) increased during the last 5 years. No significant difference in overall clinical performance was recorded between the two adhesives (p > 0.05). Changes in the medical health of some patients and recurrence of abrasion/erosion/abfraction increased the failure rate and retention rate.

CONCLUSION: After 14 years, restorations bonded with the HEMA-free 1SEa performed as well as those bonded with the 3E&Ra gold standard. Unacceptable marginal deterioration was the main reason for failure, followed by loss of retention.

PMID:37435814 | DOI:10.3290/j.jad.b4208859

Cephalalgia. 2023 Jul;43(7):3331024231187132. doi: 10.1177/03331024231187132.

ABSTRACT

OBJECTIVE: To investigate the efficacy and safety of injecting onabotulinum toxin A (BTA) towards the sphenopalatine ganglion (SPG) using the MultiGuide® in patients with persistent idiopathic facial pain (PIFP).

METHODS: This cross-over, exploratory study compared the injection of 25 units BTA versus placebo in patients who met modified ICDH-3 criteria for PIFP. Daily pain diaries were registered for a 4-week baseline, a 12-week follow-up after each injection, and an 8-week conceptual washout period in between. The primary efficacy endpoint was the change from baseline to weeks 5-8 in average pain intensity using a numeric rating scale. Adverse events were recorded.

RESULTS: Of 30 patients who were randomized to treatment, 29 were evaluable. In weeks 5-8, there was no statistically significant difference in average pain intensity between BTA versus placebo (0.00; 95% CI = -0.57 to 0.57) (P = 0.996). Following both BTA and placebo injections, five participants reported at least a 30% reduction in average pain during weeks 5-8 (P = 1.000). No serious adverse events were reported. Post-hoc analyses indicated a possible carry-over effect.

CONCLUSIONS: Injection of BTA toward the SPG with the MultiGuide® did not appear to provide a reduction in pain reduction at 5-8 weeks, although this finding may be influenced by a carry-over effect. The injection appears to otherwise be safe and well-tolerated in patients with PIFP.Trial Registration: The study protocol is registered in ClinicalTrial.gov (NCT03462290) and EUDRACT (number: 2017-002518-30).

PMID:37435807 | DOI:10.1177/03331024231187132

Elife. 2023 Jul 12;12:e83868. doi: 10.7554/eLife.83868. Online ahead of print.

ABSTRACT

Calcineurin B homologous protein 3 (CHP3) is an EF-hand Ca²⁺-binding protein involved in regulation of cancerogenesis, cardiac hypertrophy and neuronal development through interactions with sodium/proton exchangers (NHEs) and signalling proteins. While the importance of Ca²⁺ binding and myristoylation for CHP3 function has been recognized, the underlying molecular mechanism remained elusive. In this study, we demonstrate that Ca²⁺ binding and myristoylation independently affect the conformation and functions of human CHP3. Ca²⁺ binding increased local flexibility and hydrophobicity of CHP3 indicative of an open conformation. The Ca²⁺-bound CHP3 exhibited a higher affinity for NHE1 and associated stronger with lipid membranes compared to the Mg²⁺-bound CHP3, which adopted a closed conformation. Myristoylation enhanced the local flexibility of CHP3 and decreased its affinity to NHE1 independently of the bound ion, but did not affect its binding to lipid membranes. The data exclude the proposed Ca²⁺-myristoyl switch for CHP3. Instead, a Ca²⁺-independent exposure of the myristoyl moiety is induced by binding of the target peptide to CHP3 enhancing its association to lipid membranes. We name this novel regulatory mechanism ‘target-myristoyl switch’. Collectively, the interplay of Ca²⁺ binding, myristoylation, and target binding allows for a context-specific regulation of CHP3 functions.

PMID:37435805 | DOI:10.7554/eLife.83868

Curr Med Res Opin. 2023 Jul 12:1-18. doi: 10.1080/03007995.2023.2234727. Online ahead of print.

ABSTRACT

OBJECTIVE: To describe utilization patterns, negative clinical outcomes and economic burden of patients diagnosed with osteoarthritis (OA) of the hip and/or knee who received a prescription for tramadol or non-tramadol opioids vs. non-opioid drugs.

METHODS: Optum Healthcare Solutions, Inc. commercial claims data were used (1/2012-3/2017). Adults with ≥2 diagnoses of OA of the hip and/or knee, and ≥30 days supply of pain medications were identified during the three-year period from the date of first prescription (index date) after the first OA diagnosis. Drug utilization statistics in the follow-up period were summarized by initial treatment (i.e., tramadol, non-tramadol opioids, non-opioid drugs). Opioid initiators were matched to those initiated on non-opioid treatments using a propensity score model accounting for baseline characteristics. Matched pairs analysis compared outcomes for these cohorts.

RESULTS: Of 62,715 total patients, 15,270 (24.3%) initiated treatment with opioids, including 3,513 (5.6%) on tramadol and 11,757 (18.7%) on non-tramadol opioids. Opioid initiators had more comorbidities, higher baseline healthcare costs, and were more likely to have OA of the hip. Among non-opioid initiators, 27.5% switched to tramadol and 63% switched to non-tramadol opioids. Among tramadol initiators, 71% switched to non-tramadol opioids. Patients initiated on opioids had 20.4% (p < 0.01) higher all-cause healthcare costs and higher percentages experiencing multiple negative clinical outcomes (all p < 0.01) compared to matched controls.

CONCLUSIONS: Most patients with OA of the hip and/or knee either initiate on or switch to opioids for long-term management of OA-related pain despite known risks. This highlights the need for new treatments that delay or prevent use of opioids.

PMID:37435803 | DOI:10.1080/03007995.2023.2234727