Tag: pubmed

J Periodontol. 2022 Oct 24. doi: 10.1002/JPER.22-0075. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this systematic review was to assess the efficacy of three biologics, namely autologous blood-derived products (ABPs), enamel matrix derivatives (EMD) and recombinant human platelet-derived growth factor BB (rhPDGF-BB), in root coverage and gingival augmentation therapy.

METHODS: The protocol of this PRISMA 2020-compliant systematic review was registered in PROSPERO (CRD42021285917). After study selection, data of interest were extracted. A network meta-analysis (NMA) was conducted to assess the effect of different surgical interventions on the main clinical outcomes of interest (i.e., mean root coverage [MRC%], complete root coverage [CRC%], keratinized tissue width [KTW], gingival thickness [GT] change, and recession depth [RD] reduction).

RESULTS: A total of 48 trials reported in 55 articles were selected. All studies reported on the treatment of gingival recession defects for root coverage purposes. Forty-six treatment arms from 24 trials were included in the NMA. These arms consisted of treatment with coronally advanced flap (CAF) alone, EMD + CAF, platelet-rich fibrin (PRF) + CAF, and subepithelial connective tissue graft (SCTG) + CAF. Regarding MRC%, SCTG+CAF was associated with a significant higher estimate (13.41%, 95% CI [8.06-18.75], P < 0.01), while EMD+CAF (6.68%, 95% CI [-0.03 to 13.4], P = 0.061) and PRF+CAF (1.03%, 95% CI [-5.65 to 7.72], P = 0.71) failed to show statistically significant differences compared with CAF alone (control group) or with each other. Similarly, only SCTG+CAF led to a significantly higher CRC% (14.41%, 95% CI [4.21 to 24.61], P < 0.01), while treatment arms EMD + CAF (13.48%, 95% CI [-3.34 to 30.32], P = 0.11) and PRF+CAF (-0.91%, 95% CI [-15.38, 13.57], p = 0.81) did not show significant differences compared with CAF alone or with each other. Differences in the CI of PRF+CAF (symmetrical around a zero adjunctive effect) and EMD+CAF (non-symmetrical) suggest that EMD could have some additional value compared with PRF. Treatment with SCTG+CAF led to a statistically significant higher RD reduction (-0.39 mm, 95% CI [-0.55 to 0.22], P < 0.01), however EMD+CAF (-0.13 mm, 95% CI [-0.29 to 0.01], P = 0.08) and PRF+CAF (-0.06 mm, 95% CI [-0.23 to 0.09], P = 0.39) failed to show significant differences compared with CAF or with each other. While SCTG+CAF was associated with a statistically significant higher gain of KTW (0.71 mm, 95% CI [0.48 to 0.93], P < 0.01), EMD+CAF (0.24 mm, 95% CI [-0.02 to 0.51], P = 0.08) and PRF+CAF (0.08 mm, 95% CI [-0.23 to 0.41], P = 0.58) did not result into significant changes compared with CAF alone or with each other. Regarding the use of rhPDGF-BB+CAF, although available studies have reported equivalent results compared with SCTG+CAF, evidence is very limited.

CONCLUSIONS: The use of ABPs, EMD, or rhPDGF-BB in conjunction with a CAF for root coverage purposes is safe and generally promotes significant improvements respective to baseline clinical parameters. However, the adjunctive use of ABPs and EMD does not provide substantial additional improvements in terms of clinical outcomes and patient-reported outcome measures to those achieved using CAF alone, when baseline KTW is >2 mm. Both PRF+CAF and EMD+CAF rendered inferior MRC%, CRC%, RD reduction, and KTW gain compared with SCTG+CAF, which should still be considered the gold-standard in root coverage therapy. Although some studies have reported equivalent results for rhPDGF-BB+CAF compared with the gold-standard intervention, limited evidence precludes formal comparisons with CAF or SCTG+CAF that could be extrapolated to guide clinical practice.

PMID:36279123 | DOI:10.1002/JPER.22-0075

J Periodontol. 2022 Oct 24. doi: 10.1002/JPER.22-0120. Online ahead of print.

ABSTRACT

BACKGROUND: A large variety of biomaterials, biologics and membranes have been utilized in the past 40 years for the regenerative treatment of periodontal infrabony defects. Biologic agents have progressively gained popularity among clinicians and are routinely used for periodontal regeneration. In alignment with the goals of the American Academy of Periodontology (AAP) Best Evidence Consensus (BEC) on the use of biologic mediators in contemporary clinical practice, the aim of this sytematic review was to evaluate the effect of biologic agents, specifically autogenous blood-dervied products (ABPs), enamel matrix derivative (EMD) and recombinant human platelet-derived growth factor-BB (rhPDGF-BB), on the regenerative outcomes of infrabony defects.

METHODS: A detailed systematic search was conducted to identify eligible randomized control trials (RCTs) reporting the outcomes of periodontal regenerative therapy using biologics for the treatment of infrabony defects. A frequentist mixed-modeling approach to network meta-analysis (NMA), characterized by the assessment of three individual components for the treatment of an infrabony defect (the bone graft material [BG], the biologic agent, the application of a barrier membrane) was performed to evaluate and compare the relative efficacy of the different components, on the outcomes of different therapeutic modalities of periodontal regeneration.

RESULTS: A total of 153 eligible RCTs were included, with 150 studies contributing to the NMA. The quantitative analysis showed that the addition of biologic agents to bone graft significantly improves the clinical and radiographic outcomes, as compared to BG and flap procedures alone. Barrier membranes enhanced the regenerative outcomes of BG but did not provide further benefits in combination with biologics. The type of BG (autogenous, allogeneic, xenogeneic or alloplastic) and the biologic agent (EMD, platelet-rich fibrin [PRF], platelet-rich plasma [PRP] or rhPDGF-BB) played a significant role on the final outcomes of infrabony defects. Allogeneic and xenogeneic BGs exhibited statistically significantly superior clinical gain than synthetic and autogenous BGs (p < 0.05 in all the comparisons), while rhPDGF-BB and PRF demonstrated significantly higher stability of the gingival margin (p < 0.01) and radiographic bone fill/gain (p < 0.05), together with greater, although not statistically significant, clinical attachment level gain and pocket depth reduction, than EMD and PRP. Overall, rhPDGF-BB exhibited the largest effect size for most parameters, including clinical attachment level gain, pocket depth reduction, less gingival recession and radiographic linear bone gain. Considering the relatively high number of trials presenting an unclear or high risk of bias, the strength of recommendation supporting the use of PRP was judged weak, while the recommendation for EMD, PRF and rhPDGF-BB was deemed in favor.

CONCLUSIONS: Biologics enhance the outcomes of periodontal regenerative therapy. Combination therapies involving BGs + biologics or BGs + barrier membrane demonstrated to be superior to monotherapies. The choice of the type of BG and biologic agent seems to have significant impact on the clinical and radiographic outcomes of infrabony defects.

PMID:36279121 | DOI:10.1002/JPER.22-0120

Endocr Connect. 2022 Oct 1:EC-22-0325. doi: 10.1530/EC-22-0325. Online ahead of print.

ABSTRACT

We assessed the prevalence of two novel islet autoantibodies, those targeting ubiquitin-conjugating enzyme 2L3 (UBE2L3) and eukaryote translation elongation factor 1 α1 (eEF1A1), in type 1 diabetes mellitus (T1DM) to evaluate their utility in T1DM diagonsis with comparison to other islet autoantibodies. We also aimed to determined whether age and ethnicity impacted their diagnostic value. Electrochemiluminescence (ECL) assay was used to detect UBE2L3-Ab and eEF1A1-Ab in 193 Chinese Han and 570 American Caucasian subjects with T1DM, 282 Chinese Han and 199 American Caucasian controls. In Chinese and American cohorts, the UBE2L3-Ab cut-off indices were 0.039 and 0.038, and the eEF1A1-Ab cut-off indices were 0.048 and 0.050, respectively. The prevalence of UBE2L3-Ab was significantly higher in the Chinese (9.33%) and American(3.86%) subjects with T1DM than in the controls (p<0.05). The prevalence of UBE2L3-Ab in T1DM were significantly higher in Chinese than in American (p<0.05). Albeit not statistically significant, the prevalence of UBE2L3-Ab in T1DM was slightly higher in children than in adults in both ethnicity. The differences in eEF1A1-Ab levels between subjects with T1DM and controls was not significant. Meanwhile, all American subjects with UBE2L3-Ab also harbored GADA or IAA. In contrast, 2.07% of the Chinese subjects with UBE2L3-Ab positive were previously classified as autoantibody-negative based on GADA and IAA. So the prevalence of UBE2L3-Ab in T1DM patients was significantly higher than in controls and was variable according to ethnicity as well as tend to be higher in children than adults. However, UBE2L3-Ab and eEF1A1-Ab may not reliable diagnostic biomarker for T1DM.

PMID:36279111 | DOI:10.1530/EC-22-0325

J Gastrointest Surg. 2022 Oct 24. doi: 10.1007/s11605-022-05495-7. Online ahead of print.

ABSTRACT

BACKGROUND: Evidence for adjuvant chemotherapy in gallbladder cancer (GBC) is conflicting, with a postulated beneficial effect reported in T2 stage or higher, and node-positive tumours. This study aims to assess the survival benefit of peri-operative chemotherapy in stage II (pT2N0) GBCs.

METHODS: A retrospective analysis of stage II GBCs who underwent curative surgical resection was done. Patients receiving neo-adjuvant therapy (NACT) prior to resection of the gallbladder primary were excluded. Primary endpoint was disease-free survival, and outcomes of patients who received chemotherapy were compared to those who did not. Survival curves were plotted using a Kaplan-Meier analysis and difference between the survival curves was analysed using a log-rank test.

RESULTS: Two hundred seventy-six patients of stage II GBC were included, of whom 188 (68.1%) received chemotherapy and 88 (31.8%) did not. Forty-one (21.8%) patients received chemotherapy in the neo-adjuvant setting. There was no significant difference in the survival of patients who did and did not receive chemotherapy (5-year DFS 67.8% vs 66%, p = 0.795). There was no significant difference in the survival of patients who received chemotherapy in the adjuvant or neo-adjuvant setting (5-year DFS 66.4% vs 71.8%, p = 0.541). There was no statistically significant difference in the survival of patients with high-risk histologic features and who did and did not receive chemotherapy (3-year DFS 72.4% vs 56%; p = 0.379).

CONCLUSIONS: Routine use of chemotherapy, either in the adjuvant or neo-adjuvant setting, offers no survival advantage in stage II (pT2N0) gallbladder cancers.

PMID:36279092 | DOI:10.1007/s11605-022-05495-7

Clin Rheumatol. 2022 Oct 24. doi: 10.1007/s10067-022-06417-3. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the effects of telerehabilitation vs home-based exercise programs for knee osteoarthritis (KOA).

METHOD: Patients diagnosed with moderate/mild KOA were enrolled in the study and randomized into two groups. The patients in the telerehabilitation group did their exercises via video conference simultaneously, accompanied by a physiotherapist, while the patients in the control group were given a brochure showing how to do the exercises and explaining how to do each exercise. Patients completed 30-s chair stand test (30 CST), Knee Injury and Osteoarthritis Outcome Score (KOOS), Numeric Rating Scale (NRS), International Physical Activity Questionnaire Short Form (IPAQ-SF), Hospital Anxiety and Depression Scale (HADS), TAMPA Kinesiophobia Scale (TKS), Fatigue Severity Scale (FSS) twice before and after 8-week treatment, and Quality Indicators Questionnaire for Physiotherapy Management of Hip and Knee Osteoarthritis (QUIPA) and Exercise Adherence Rating Scale (EARS) after treatment only. Moreover, the number of painkillers that patients used in the last 15 days was recorded before and after treatment, and patient satisfaction with treatment was questioned after treatment.

RESULTS: Forty-eight patients were included in the study. The mean age of patients was 55.83 ± 6.93 years, and 43 (89.6%) patients were women. No significant differences were determined between groups in terms of baseline characteristics. After the 8-week follow-up, telerehabilitation group demonstrated better 30 CST, IPAQ-SF, KOOS, QUIPA, treatment satisfaction, and total and C subscale of EARS scores increment and greater NRS, HADS, TKS, and FSS score reduction than the control group. It was determined that there was a statistically significant difference between the telerehabilitation and control groups for all of the specified parameters; however, no statistically significant difference was found for the B subscale of EARS.

CONCLUSION: This study indicated that telerehabilitation is superior to self-management. Moreover, through this innovative and population specific web-based approach for KOA, a vast number of patients who have internet access could be reached. Thus, patients with KOA received effective treatment.

PMID:36279075 | DOI:10.1007/s10067-022-06417-3

Environ Sci Pollut Res Int. 2022 Oct 24. doi: 10.1007/s11356-022-23586-5. Online ahead of print.

ABSTRACT

The energy economics literature lacks a consensus on the short- and long-term linkages along with the Granger causality direction between economic growth and energy consumption. This paper examines the relationships between economic growth, fossil fuel and renewable energy consumption, CO₂ emissions, temperature, and population in 56 countries from 1990 to 2019. We contribute to the literature by uniquely grouping countries by climate zone (i.e., tropical, arid, temperate, and continental) following the Köppen-Geiger climate classification approach and employing a panel structural vector autoregressive model (P-SVAR) to study these relationships. In addition, rather than mistakenly using a single energy consumption variable, we divide it into two categories: fossil fuel and renewable energy consumption. Our findings indicate that temperature change has the most negligible impact on economic growth, while CO₂ and renewable energy have the two most significant effects. Our Granger causality tests support all four hypotheses (growth, feedback, conservative, and neutral) that describe the relationship between economic performance and energy consumption, indicating the level of difficulty in recommending an overarching energy policy worldwide. We find that conservative energy consumption and clean energy policies that avoid CO₂ emissions may benefit the selected countries’ economic prosperities.

PMID:36279061 | DOI:10.1007/s11356-022-23586-5

Environ Sci Pollut Res Int. 2022 Oct 24. doi: 10.1007/s11356-022-23732-z. Online ahead of print.

ABSTRACT

To assess the status of hotspots and research trends on geographic information system (GIS)-based landslide susceptibility (LS), we analysed 1142 articles from the Thomas Reuters Web of Science Core Collection database published during 2001-2020 by combining bibliometric and content analysis. The paper number, authors, institutions, corporations, publication sources, citations, and keywords are noted as sub/categories for the bibliometric analysis. Thematic LS data, including the study site, landslide inventory, conditioning factors, mapping unit, susceptibility models, and mode fit/prediction performance evaluation, are presented in the content analysis. Then, we reveal the advantages and limitations of the common approaches used in thematic LS data and summarise the development trends. The results indicate that the distribution of articles shows clear clusters of authors, institutions, and countries with high academic activity. The application of remote sensing technology for interpreting landslides provides a more convenient and efficient landslide inventory. In the landslide inventory, most of the sample strategies representing the landslides are point and polygon, and the most frequently used sample subdividing strategy is random sampling. The scale effects, lack of geographic consistency, and no standard are key problems in landslide conditioning factors. Feature selection is used to choose the factors that can improve the model’s accuracy. With advances in computing technology and artificial intelligence, LS models are changing from simple qualitative and statistical models to complex machine learning and hybrid models. Finally, five future research opportunities are revealed. This study will help investigators clarify the status of LS research and provide guidance for future research.

PMID:36279056 | DOI:10.1007/s11356-022-23732-z

Obes Surg. 2022 Oct 24. doi: 10.1007/s11695-022-06330-3. Online ahead of print.

ABSTRACT

BACKGROUND: Single-nucleotide polymorphisms (SNPs) associated with obesity predict laparoscopic Roux-en-Y gastric bypass (LRYGB) and biliopancreatic diversion with duodenal switch (BPD/DS) for weight loss with good efficiency. However, prediction of weight loss after laparoscopic sleeve gastrectomy using SNPs has not been well investigated.

OBJECTIVES: To predict weight loss after laparoscopic sleeve gastrectomy using obesity-related SNPs and clinical variants in Chinese patients with body mass index (BMI) ≥ 32.5 kg/m².

METHODS: We detected 29 SNPs. Binary logistic regression was used to screen SNPs and clinical variables with predictive value. Receiver operating characteristic (ROC) curves were plotted for clinical variables, SNPs, and their combination, and areas under the ROC curve (AUC) were compared. Internal and external validation tests were performed.

RESULTS: rs12535708, rs651821, and rs5082 were constructed as the genetic risk score (GRS). Preoperative BMI was constructed as the clinical risk score (CRS). Preoperative BMI and SNPs were constructed as the cumulative genetic risk score (CGRS). ROC curves of GRS, CRS, and CGRS showed that the optimal cutoffs were 0.831 (AUC = 0.840; sensitivity, 92.96%; specificity, 64.29%), 43.46 kg/m² (AUC = 0.830; sensitivity, 76.06%; specificity, 85.71%), and 0.921 (AUC = 0.931; sensitivity, 77.46%; specificity, 92.86%), respectively. The AUC of CGRS was significantly greater than that of CRS (P < 0.05) and greater than GRS without statistical significance.

CONCLUSION: In Chinese patients with BMI ≥ 32.5 kg/m², GRS and CRS could predict weight loss success. However, CGRS was superior to GRS or CRS alone.

PMID:36279045 | DOI:10.1007/s11695-022-06330-3

Ir J Med Sci. 2022 Oct 24. doi: 10.1007/s11845-022-03199-0. Online ahead of print.

ABSTRACT

BACKGROUND: Hyponatremia is the most common electrolyte disorder in lung cancer, and it particularly occurs in small cell lung cancer (SCLC) patients. The prognostic significance of hyponatremia has been reported in several studies with controversial results.

AIMS: We aimed in this study to investigate hyponatremia and evaluate its prognostic value in SCLC patients.

METHODS: The data of 373 SCLC patients were analyzed retrospectively. Serum sodium concentrations were measured from blood samples taken from all patients before treatment. Hyponatremia was defined as a serum sodium concentration below 135 mmol/L and then assigned into two groups: mild (130 to 134 mmol/L) and severe (below ≤ 129 mmol/L) hyponatremia.

RESULTS: Hyponatremia was detected in 85 (22.8%) patients (mild hyponatremia in 51 (13.7%) and severe hyponatremia in 34 (9.1%) patients). Furthermore, 26% (63 of 242) of ED-SCLC patients and 16.8% (22 of 131) of LD-SCLC patients had hyponatremia. While no clinical parameter was statistically associated with serum sodium concentrations in LD-SCLC patients, hyponatremic ED-SCLC patients were more frequently associated with weight loss (p = 0.04) and liver metastasis (p = 0.04). In LD-SCLC, the overall survival (OS) rates of patients with hyponatremia were similar to those with normonatremia (p = 0.6). Likewise, hyponatremic and normonatremic ED-SCLC patients had similar life expectancies (p = 0.1). Moreover, the severity of hyponatremia did not affect OS in either LD-SCLC (p = 0.3) or ED-SCLC (p = 0.1).

CONCLUSION: Serum sodium concentration did not have an impact on survival in SCLC patients; thus, we concluded that neither the presence nor the severity of hyponatremia affected the outcome of these patients.

PMID:36279041 | DOI:10.1007/s11845-022-03199-0

Infection. 2022 Oct 24. doi: 10.1007/s15010-022-01931-7. Online ahead of print.

ABSTRACT

PURPOSE: We hypothesized that SARS-CoV-2 infection numbers reported by governmental institutions are underestimated due to high dark figures as only results from polymerase chain reaction (PCR) tests are incorporated in governmental statistics and testing capacities were further restricted as of July, 2022.

METHODS: A point prevalence investigation was piloted by rapid antigen testing (RAT) among participants of the VACCELERATE volunteer registry. 2400 volunteers were contacted, of which 500 received a RAT including instructions for self-testing in the first week of July, 2022. Results were self-reported via e-mail.

RESULTS: 419 valid RAT results were collected until July 7th, 2022. Between July-1 and July-7, 2022, 7/419 (1.67%) tests were positive. Compared to reports of the German Federal Government, our results suggest a more than twofold higher prevalence. Three out of seven positive individuals did not have a PCR test and are therefore likely not to be displayed in governmental statistics.

CONCLUSION: Our findings imply that the actual prevalence of SARS-CoV-2 may be higher than detected by current surveillance systems, so that current pandemic surveillance and testing strategies may be adapted.

PMID:36279033 | DOI:10.1007/s15010-022-01931-7