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Fracture strength of anterior cantilever resin bonded fixed partial dentures fabricated from high translucency zirconia with different intaglio surface treatments

J Prosthodont. 2023 Apr 28. doi: 10.1111/jopr.13694. Online ahead of print.

ABSTRACT

PURPOSE: To compare the fracture resistance and failure modes of anterior cantilever resin-bonded fixed partial dentures (RBFPDs) fabricated from high translucency zirconia with different intaglio surface treatments.

MATERIALS AND METHODS: Sound-extracted canines (N = 50) were randomly divided into five groups (n = 10), to be restored with high translucency zirconia RBFBDs of different intaglio surface treatments. The RBFPD was designed using an exocad software and fabricated using a CAM milling machine. The RBFPDs were treated differently. Abrasion with 50μm alumina particles (Group 1); abrasion with 30μm silica-coated alumina particles (Group 2); abrasion with silica-coated alumina particles (30μm) and silane application (Group 3); abrasion with silica coated alumina particles (30μm) and 10-MDP primer application (Group 4); abrasion with silica-coated alumina particles (30μm) and silane, and 10-MDP primer application. All RBFPDs were cemented using dual-cured resin cement. The RBFPDs underwent 6000 thermal cycles with distilled water at 5°C/55°C for 2 minutes per cycle and then mechanical cyclic loading with 1,200,000 cycles of 50 N at a 1.7Hz frequency at an angle of 135° to the abutment’s long axis. Then, RBFPDs were loaded to fracture using a universal testing machine at 1mm/min. Maximum fracture forces and failure modes were recorded. Fractured specimens and uncemented specimens were examined using a scanning electron microscope. Data were analyzed using ANOVA and Games-Howell post hoc tests at P<0.05.

RESULTS: Mean fracture load results showed a statistically significant difference between the research groups (P<0.0001) and it ranged from 69.78-584 N. Group 4 exhibited the highest fracture load mean (P < 0.0001) which was significantly different from all other groups. Group 2 recorded a significantly higher fracture load mean than Group 3 (P = 0.029). Three modes of failure were observed; prosthesis debonding, prosthesis fracture, and abutment fracture.

CONCLUSIONS: Abrasion of zirconia surface with 30μm silica-coated alumina particles and application of 10-MDP primer yielded the highest mean fracture loads of monolithic high translucency zirconia RBFPD. The mode of fracture of the RBFPDs was influenced by the type of surface treatments. This article is protected by copyright. All rights reserved.

PMID:37114526 | DOI:10.1111/jopr.13694

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Paraproteins and electrolyte assays: exclusion effect and effect of paraprotein elimination

Scand J Clin Lab Invest. 2023 Apr 28:1-7. doi: 10.1080/00365513.2023.2204401. Online ahead of print.

ABSTRACT

Paraproteins are a potential source of error for electrolyte analyses. The exclusion effect itself causes a discrepancy between direct and indirect ion selective electrode assays (dISE and iISE, respectively). We tested the applicability of different pretreatment methods and the difference of dISE and iISE with paraprotein-rich samples. We analysed chloride (Cl-), potassium (K+), and sodium (Na+) on 46 samples with paraproteins up to 73 g/L. We compared pretreatment methods of preheating, precipitation, and filtration to the native sample. All induced a statistically significant difference (p-value <0.05). Clinically significant difference was induced by precipitation for all analytes, and filtration for Cl- and Na+, but for none by preheating. The difference in electrolyte measurements with either dISE or iISE on native samples was explained by total protein concentration (TP). There was a statistically significant difference in all electrolyte measurements. On average, there was a clinically significant difference in Na + but not in Cl- and K + measurements. Paraprotein concentration (PP) or heavy chain class did not induce a statistically significant effect. The regression analysis and comparison to the theoretical exclusion effect supported the conclusion that TP is the only explanatory factor in the difference between dISE and iISE. We conclude that preheating is a suitable pretreatment method for all the studied analytes. Precipitation is not valid for any of them, and filtration can be considered only for K+. Because the difference between dISE and iISE was explained by the exclusion effect caused by TP, dISE is the more suitable method to analyse paraprotein-rich samples.

PMID:37114525 | DOI:10.1080/00365513.2023.2204401

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Similar geographic distributions of death rates from inflammatory bowel disease and Hodgkin lymphoma or multiple sclerosis

United European Gastroenterol J. 2023 Apr 28. doi: 10.1002/ueg2.12398. Online ahead of print.

ABSTRACT

BACKGROUND: A previous comparative analysis of the time trends of Hodgkin lymphoma (HL), multiple sclerosis (MS), Crohn’s disease (CD), and ulcerative colitis (UC) suggested that the occurrence of all four diseases was precipitated by exposure to similar environmental risk factors during early lifetime. In the present cross-sectional study, it was hypothesized that besides their resembling temporal variations the four diseases would also show similar geographic distributions.

METHODS: Using the vital statistics of 21 countries from 1951 to 2020, overall and age-specific death rates from the four diseases were calculated for each individual country. The death rates of different countries were compared using linear regression analysis.

RESULTS: The data revealed strikingly similar geographic distributions of all four diseases. Their occurrence was common in Europe and relatively uncommon in countries outside Europe. Further stratification by consecutive age groups showed that for each disease analyzed separately, there were significant correlations amongst each two sequential age groups. In HL and UC, the inter-age correlations started at age 5 years or less. In MS and CD, the inter-age correlations only started at age 15 years.

CONCLUSIONS: The similarities in the geographic distributions of death rates from HL, MS, CD, and UC suggest that these four diseases share a set of one or more common environmental risk factors. The data also support the contention that the exposure to such shared risk factors starts during an early period of lifetime.

PMID:37114502 | DOI:10.1002/ueg2.12398

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COVID-19 in maternal, perinatal and neonatal mortality in four locations in Bogotá. Descriptive study.

Rev Esp Salud Publica. 2023 Apr 26;97:e202304034.

ABSTRACT

OBJECTIVE: The multiple effects of the COVID-19 pandemic are beginning to be seen from the alteration of vital statistics figures. This is summarized in changes in the usual causes of death and excess attributable mortality, which can finally be seen in structural changes in the populations of the countries. For this reason, this research was created with the objective of determining the impact of the COVID-19 pandemic on maternal, perinatal and neonatal mortality in four locations in Bogotá D.C. (Colombia).

METHODS: A retrospective longitudinal investigation was carried out in which 217,419 mortality data were analyzed in the towns of Kennedy, Fontibón, Bosa and Puente Aranda in the city of Bogotá – Colombia that occurred between the years 2018 to 2021, of which maternal (54), perinatal (1,370) and neonatal (483) deaths in order to identify a history of SARS-CoV-2 infection that could be related to the excess mortality associated with COVID-19. The data were collected from the open records of vital statistics of the National Statistics Department (DANE), where they were analyzed from frequency measures or central tendency and dispersion according to the types of variables. The specific mortality indicators related to maternal, perinatal and neonatal death events were calculated.

RESULTS: A decrease in perinatal and neonatal mortality was evidenced since 2020, which was associated with the progressive decrease in pregnancies in those same years; Additionally, a considerable increase in maternal deaths was observed for 2021 compared to the other years analyzed. The proportion of maternal deaths in 2020 and 2021 by 10% and 17%, respectively, were attributed to COVID-19.

CONCLUSIONS: It is observed that the trend of maternal mortality is related to the increase in mortality from COVID-19, maternal deaths associated with COVID-19 occurred specifically in the zonal planning units that registered more than 160 cases of COVID-19 for the year 2021.

PMID:37114485

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Long term epilepsy outcome dynamics revealed by natural language processing of clinic notes

Epilepsia. 2023 Apr 28. doi: 10.1111/epi.17633. Online ahead of print.

ABSTRACT

OBJECTIVE: Electronic medical records allow for retrospective clinical research with large patient cohorts. However, epilepsy outcomes are often contained in free text notes that are difficult to mine. We recently developed and validated novel natural language processing (NLP) algorithms to automatically extract key epilepsy outcome measures from clinic notes. In this study, we assessed the feasibility of extracting these measures to study the natural history of epilepsy at our center.

METHODS: We applied our previously validated NLP algorithms to extract seizure freedom, seizure frequency, and date of most recent seizure from outpatient visits at our epilepsy center from 2010 – 2022. We examined the dynamics of seizure outcomes over time using Markov model-based probability and Kaplan-Meier analyses.

RESULTS: Performance of our algorithms on classifying seizure freedom was comparable to that of human reviewers (algorithm F1 0.88 vs. human annotator κ 0.86). We extracted seizure outcome data from 55,630 clinic notes from 9,510 unique patients written by 53 unique authors. Of these, 30% were classified as seizure-free since the last visit; 48% of non-seizure free visits contained a quantifiable seizure frequency; and 47% of all visits contained the date of most recent seizure occurrence. Among patients with at least five visits, the probabilities of seizure freedom at the next visit ranged from 12% to 80% in patients having seizures or seizure free at the prior three visits, respectively. Only 25% of patients who were seizure free for 6 months remained seizure free after 10 years.

SIGNIFICANCE: Our findings demonstrate that epilepsy outcome measures can be extracted accurately from unstructured clinical note text using NLP. At our tertiary center, the disease course often followed a remitting and relapsing pattern. This method represents a powerful new tool for clinical research with many potential uses and extensions to other clinical questions.

PMID:37114472 | DOI:10.1111/epi.17633

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Increased markers of inflammation after cannabis cessation, and their association with psychotic symptoms

Acta Neuropsychiatr. 2023 Apr 28:1-29. doi: 10.1017/neu.2023.24. Online ahead of print.

ABSTRACT

INTRODUCTION: A dysbalance of the immune system in psychotic disorders has been well investigated. However, despite a higher prevalence of cannabis (THC) consumption in patients with psychosis, few studies have investigated the impact of this use on inflammatory markers.

METHODS: One hundred and two inpatients were included in this retrospective study. Leukocytic formula, hsCRP, fibrinogen levels and urinary THC were measured, and comparisons were performed at baseline and after 4 weeks of cannabis cessation between cannabis users (THC+) and non-users (THC-).

RESULTS: After cannabis cessation, we found a greater increase of leucocyte level (p < 0.01), monocyte level (p = 0.05) and a statistical trend to a highest increase of lymphocyte level (p = 0.06) between baseline and 4 weeks in the THC+ group as compared to the THC- group. At 4 weeks, highest leucocyte (p = 0.03), lymphocyte (p = 0.04) and monocyte (p < 0.01) counts were found in the THC+ group whereas at baseline no difference was found. A positive correlation was found between monocyte count at 4 weeks and baseline PANSS negative subscore (p = 0.045) and between the variation of monocyte count between baseline and 4 weeks and the PANSS total score at 4 weeks (p = 0.05).

CONCLUSION: THC cessation is associated with an increase in inflammatory markers, including white blood cell, lymphocyte, and monocyte levels, which correlates with symptomatology of patients with psychosis.

PMID:37114467 | DOI:10.1017/neu.2023.24

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Clinical significance of drug cessation on medication-related osteonecrosis of the jaw in patients with osteoporosis

J Korean Assoc Oral Maxillofac Surg. 2023 Apr 30;49(2):75-85. doi: 10.5125/jkaoms.2023.49.2.75.

ABSTRACT

OBJECTIVES: Suspending bisphosphonates (BPs) to reduce the risk and severity of medication-related osteonecrosis of the jaw (MRONJ) remains controversial. In this study, we quantitatively evaluated the clinical significance of BP suspension before surgery in osteoporosis patients with MRONJ.

MATERIALS AND METHODS: We analyzed 24 osteoporosis patients with MRONJ who were treated from 2012 to 2020 at Seoul National University Dental Hospital and compared the treatment outcomes of those who suspended BPs with those who did not. The number of surgical interventions, follow-up panoramic radiographs for relative bone density measurement, and laboratory blood tests including white blood cells, erythrocyte sedimentation rate, absolute neutrophil count, hemoglobin, hematocrit, and alkaline phosphatase were analyzed. ANOVA, Student’s t -test, and Mann-Whitney U tests were used to compare results. Fisher’s exact test was used to discover the association between treatment outcome and BP suspension, and Pearson’s correlation test was used to measure the statistical relationship between the changes in serum inflammatory markers.

RESULTS: The number of interventions was significantly higher in the non-drug suspension group due to recurrence (p<0.05). The relative bone density in patients who suspended BPs was significantly different over time (p<0.05), with the highest density at one-year follow-up. Fisher’s exact test shows an association between successful treatment outcomes and BP suspension. The alkaline phosphatase and erythrocyte sedimentation rate levels decreased significantly in the BP-suspended group, and a positive correlation was found between these elevated markers.

CONCLUSION: A significant increase in bone density throughout follow-up and a lower number of interventions were found in the BP suspension group compared to the non-drug suspension group. Also, BP suspension decreased inflammatory markers in the serum after surgery, resulting in good treatment outcomes. BP suspension is a prognostic factor for MRONJ and should be implemented before surgery.

PMID:37114445 | DOI:10.5125/jkaoms.2023.49.2.75

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The effect of drug holiday before tooth extraction on the development of medication-related osteonecrosis of the jaw in cancer patients receiving intravenous bisphosphonates

J Korean Assoc Oral Maxillofac Surg. 2023 Apr 30;49(2):68-74. doi: 10.5125/jkaoms.2023.49.2.68.

ABSTRACT

OBJECTIVES: Drug holidays are suggested to reduce the formation of osteonecrosis in patients under intravenous (IV) bisphosphonates (BPs) therapy. The objectives of this study are to evaluate the incidence of medication-related osteonecrosis of the jaw (MRONJ) following tooth extraction in cancer patients using IV BP, and to assess the effect of drug holiday on the development of MRONJ. Patients and.

METHODS: A manuel search of the patient folders of Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hacettepe University was undertaken to identify cancer patients who used IV BPs and had at least one tooth extraction between 2012 and 2022. Patents’ age, sex, systemic condition, the type of BP used, duration of BP used, number of tooth extraction, duration of drug holiday, localization of tooth extraction and incidence of MRONJ were recorded.

RESULTS: One hundred nine teeth were removed from 57 jaws in 51 patients. All tooth extractions were performed under perioperative antibiotic prophylaxis and with primary wound closure. The incidence of MRONJ was 5.3%. Stage 1 MRONJ developed in 3 patients (only one had a drug holiday). The median duration of drug holiday was 2 months. No significant difference between the patients with and without a drug holiday and MRONJ development was found (P=0.315). The mean age of patients developed MRONJ was 40.33±8.08 years. A statistically significant difference was found between age and MRONJ development (P=0.002).

CONCLUSION: The effect of a short-term drug holiday on the development of MRONJ may be limited because BPs remain in bone tissue for a long time. Drug holidays should be applied with the approval of an oncologist with other preventive measurements.

PMID:37114444 | DOI:10.5125/jkaoms.2023.49.2.68

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Clinical features and treatment effect of HIV-associated immune thrombocytopenia-single center Ten-Years data summary

Platelets. 2023 Dec;34(1):2200836. doi: 10.1080/09537104.2023.2200836.

ABSTRACT

Thrombocytopenia represents one of the most prevalent hematologic complications observed in patients infected with the human immunodeficiency virus (HIV). In this study, we sought to analyze the clinical characteristics and treatment outcomes of patients with coexisting HIV and thrombocytopenia. Specifically, we retrospectively examined the medical records of 45 patients diagnosed with HIV/AIDS and thrombocytopenia at the Yunnan Infectious Diseases Specialist Hospital between January 2010 and December 2020, all of whom received highly active antiretroviral therapy (HAART) with/without glucocorticoids. The median follow-up period was 79 days, ranging between 14 and 368 days, the total platelet count was higher after receiving treatment than before (Z = -5.662, P < .001). Among the cohort, 27 patients (60.0%) responded to treatment, with 12 patients (44.44%) experiencing relapse during the follow-up period. The response rate (80.00%) of newly diagnosed ITP were significantly higher than of persistent ITP (28.57%) and chronic ITP (38.46%) (x2 = 9.560, P = .008) and the relapse rate of the newly diagnosed ITP (30.00%) was significantly lower than the persistent ITP and chronic ITP (100.00%, 80.00%) (x2 = 6.750, P = .034). Notably, we found that the number of CD4+ T cells, duration of HIV infection, selection of HAART and type of glucocorticoids administered displayed no statistically significant effect on platelet count, treatment response, or relapse rate. However, we observed a significant decrease in platelet count in hepatitis C virus-positive individuals coinfected with HIV compared to those with HIV alone (Z = -2.855, P = .003). Our findings suggest that patients diagnosed with HIV and thrombocytopenia exhibit a low response rate to treatment and have an increased likelihood of relapse.

PMID:37114424 | DOI:10.1080/09537104.2023.2200836

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Comparison of the role of 18F-fluorodeoxyglucose PET/computed tomography and 68Ga-labeled FAP inhibitor-04 PET/CT in patients with malignant mesothelioma

Nucl Med Commun. 2023 Apr 28. doi: 10.1097/MNM.0000000000001702. Online ahead of print.

ABSTRACT

OBJECTIVE: In this study, we aimed to compare the role of 68Ga-labeled FAP inhibitor (68Ga-FAPI)-04 PET/computed tomography (CT) and 18F-fluorodeoxyglucose (18F-FDG) PET/CT in the evaluation of primary tumor and metastases in patients diagnosed with malignant mesothelioma.

MATERIALS AND METHODS: Our prospective study included 21 patients with histopathological diagnosis of malignant mesothelioma who underwent both 68Ga-FAPI-04 PET/CT and 18F-FDG PET/CT imaging between April 2022 and September 2022. Maximum standardized uptake value (SUVmax), metabolic tumor volume, total lesion glycolysis, tumor-to-background ratio (TBR) and highest SUVpeak (HPeak) values and lesion numbers were calculated from primary and metastatic lesions on FDG and FAPI PET/CT images. Findings obtained from FAPI and FDG PET/CT were compared.

RESULTS: More lesions were detected in 68Ga-FAPI-04 PET/CT compared to 18F-FDG PET/CT in primary tumor and lymph node metastases. Statistically significantly higher SUVmax and TBR values were found with FAPI PET/CT (primary lesion SUVmax and TBR, P = 0.001 and P < 0.001, respectively; lymph node SUVmax and TBR, P = 0.016 and P = 0.005, respectively). With FAPI PET/CT, upstage was observed according to tumor-node-metastasis staging in a total of seven patients including three patients with pleural origin, three patients with peritoneal origin and one patient with pericardial origin.

CONCLUSION: In addition to the stage change with 68Ga-FAPI-04 PET/CT in malignant mesothelioma patients, a statistically significant superiority was observed in SUVmax, TBR and volumetric parameters in primary tumors and metastases.

PMID:37114422 | DOI:10.1097/MNM.0000000000001702