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Nevin Manimala Statistics

Analyses of Bone Regeneration Capacity of Freeze-Dried Bovine Bone and Combined Deproteinized-Demineralized Bovine Bone Particles in Mandibular Defects: The Potential Application of Biological Forms of Bovine-Bone Filler

Eur J Dent. 2021 Nov 23. doi: 10.1055/s-0041-1736291. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate bone regeneration capacity of FDBX granules compared to composite DBBM/DFDBX granules for filling of bone defect in rabbit mandible.

MATERIAL AND METHODS: Critical size defects were created in 45 rabbits’ mandible. The defect in the control group is left untreated, while in other groups the defects were filled with FDBX granules and composite DBBM/DFDBX granules, respectively. Specimens were collected at 2, 4, and 8 weeks for histology and immunohistochemical analyses. Significant difference is set at p-value < 0.05.

RESULTS: The osteoblast-osteoclast quantification, osteoblast expression of Runx2, alkaline phosphatase, collagen-I, and osteocalcin, and osteoclast expression of receptor activator of NF-kB ligand (RANKL) and osteoprotegerin (OPG) in FDBX groups were statistically comparable (p > 0.05) with the composite group, while OPG/RANKL ratio, bone healing scores, and trabecular area were significantly higher (p < 0.05) in the composite compared to FDBX group.

CONCLUSION: Composite DBBM/DFDBX granules, within the limitation of this study, has better bone forming capacity than FDBX granules for filling of bone defects in the mandible.

PMID:34814221 | DOI:10.1055/s-0041-1736291

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PEEK versus Metallic Attachment-Retained Obturators for Patient Satisfaction: A Randomized Controlled Trial

Eur J Dent. 2021 Nov 23. doi: 10.1055/s-0041-1731839. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of the study is patients’ satisfaction evaluation and radiographic evaluation of the terminal abutments of attachment-retained maxillary obturators with metal framework versus milled polyetheretherketone (PEEK) framework in the management of maxillectomy cases.

MATERIALS AND METHODS: Eighteen participants were randomly divided into three parallel groups (n = 6). Participants of the PEEK group received attachment-retained obturators with milled PEEK framework, the metal group received an attachment-retained obturator with a metallic framework, and the conventional group received conventional clasp-retained obturators with a metallic framework (Control group). The evaluation included was radiographic evaluation and patients’ satisfaction in this study included two scales-“The Obturator Functioning Scale” and “The European Organization for Research and Treatment of Cancer Head and Neck 35” using one-way ANOVA test.

RESULTS: Both PEEK and metal groups showed a statistically significant lower mean bone loss (p <0.050) compared with the conventional group during all follow-up periods. There is no statistically significant difference between the PEEK and metal groups during all follow-up periods. Regarding patient satisfaction, both the PEEK and metal groups showed a statistically significant decrease score (p <0.050) compared with the conventional group in various aspects of patients’ satisfaction scales as satisfaction with the look and difficulty of talking to the public, and noticeable clasps. In comparison, the PEEK group showed a statistically significant decrease score (p <0.050) than the metal group with respect to satisfaction with the look along all follow-up periods.

CONCLUSIONS: PEEK attachment-retained maxillary definitive obturators could be considered a promising treatment modality for patients with acquired maxillary defects with regard to esthetics and satisfaction.

PMID:34814222 | DOI:10.1055/s-0041-1731839

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Increasing Use of Anticoagulants in Germany and Its Impact on Hospitalization for Tooth Extraction

Hamostaseologie. 2021 Nov 23. doi: 10.1055/a-1528-0513. Online ahead of print.

ABSTRACT

OBJECTIVES: This article aimed to compare nationwide time trends of oral anticoagulant prescriptions with the time trend of hospitalization for tooth extraction (TE) in Germany from 2006 through 2017.

PATIENTS AND METHODS: We derived the annual number of hospital admissions for TE from the Nationwide Hospital Referral File of the Federal Bureau of Statistics and defined daily doses (DDD) of prescribed anticoagulants in outpatients from reports of the drug information system of the statutory health insurance.

RESULTS: From 2005 to 2017, annual oral anticoagulation (OAC) treatment rates increased by 143.7%. In 2017, direct oral anticoagulants (DOACs) represented 57.1% of all OAC treatments. The number of cases hospitalized for TE increased by 28.0 only. From all the cases hospitalized for TE in Germany in 2006, 14.2% had a documented history of long-term use of OACs. This proportion increased to 19.6% in 2017. Age-standardized hospitalization rates for all TE cases with long-term use of OACs increased from 6.6 in 2006 to 10.5 cases per 100,000 person-years in 2014 and remained almost unchanged thereafter.

CONCLUSION: Our comparison showed that the large increase in OAC treatment rates in general from 2006 to 2017 had only a small impact on hospitalized TE cases with long-term use of OAC which flattens since 2014.

PMID:34814217 | DOI:10.1055/a-1528-0513

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Oral Health-Related Quality of Life, Dry Mouth Sensation, and Level of Anxiety in Elderly Patients Rehabilitated with New Removable Dentures

Eur J Dent. 2021 Nov 23. doi: 10.1055/s-0041-1735796. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the influence of new complete dentures (CDs) and new removable partial dentures (RPDs) on oral health-related quality of life, dry mouth sensation, and anxiety level of their wearers.

MATERIALS AND METHODS: In total, 20 complete edentulous patients (in both arches) that needed to be rehabilitated with new CDs, and 20 partial edentulous patients (in both arches) that needed to be rehabilitated with new RPDs, were included in this study. Each patient must wear the same pair of CDs or RPDs for more than 5 years. Oral health-related quality of life, dry mouth sensation, and level of anxiety were assessed by using the following questionnaires: Geriatric Oral Health Assessment Index (GOHAI), VAS (Visual Analog Scale) Xerostomia Questionnaire, and State-Trait Anxiety Inventory (STAI). These questionnaires were applied before oral rehabilitation (initially initial time point) and 3 months after insertion of new dentures (end time point).

STATISTICAL ANALYSIS: For the results of STAI-State, STAI-Trait, and GOHAI, the Wilcoxon test was applied to compare the time points. For the results of the VAS xerostomia questionnaire, two-way repeated measures ANOVA (analysis of variance) was applied, followed by the Tukey test. The p-values lower than 0.05 were considered statistically significant.

RESULTS: /CONCLUSION: For both groups, it was observed that 3 months after the insertion of new removable dentures: (1) there was an increase in oral health-related quality of life; (2) there was a reduction in anxiety (trait anxiety and state anxiety); and (3) there was a perception of greater salivation.

PMID:34814220 | DOI:10.1055/s-0041-1735796

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COVID-19-Associated Orphanhood and Caregiver Death in the United States

Pediatrics. 2021 Oct 7:e2021053760. doi: 10.1542/peds.2021-053760. Online ahead of print.

NO ABSTRACT

PMID:34814177 | DOI:10.1542/peds.2021-053760

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Inverse Association of Serum Adipsin with the Remission of Nonalcoholic Fatty-Liver Disease: A 3-Year Community-Based Cohort Study

Ann Nutr Metab. 2021 Nov 23:1-12. doi: 10.1159/000520368. Online ahead of print.

ABSTRACT

PURPOSES: Adipokine alterations contribute to the development and remission of nonalcoholic fatty-liver disease (NAFLD). Adipsin is one of the most abundant adipokines and is almost exclusively produced by adipocytes. However, data on adipsin in human NAFLD are limited and controversial. We performed this study to investigate the association between adipsin and the remission of NAFLD in middle-aged and elderly Chinese adults.

METHODS: Whether adipsin is associated with the remission of NAFLD in a 3-year community-based prospective cohort study was investigated. Baseline levels of adipsin were measured in serum samples collected from 908 NAFLD participants. NAFLD was diagnosed using abdominal ultrasonography. Logistic regression analysis and a multiple stepwise logistic regression model including different variables were conducted to evaluate the association between serum adipsin levels and the remission of NAFLD.

RESULTS: During a mean follow-up of 3.14 ± 0.36 years, 247 (27.20%) participants with NAFLD at baseline were in remission. At baseline, serum adipsin concentration was positively correlated with body mass index (r: 0.39, p < 0.001), insulin (r: 0.31, p < 0.001), and homeostasis model assessment of insulin resistance (r: 0.31, p < 0.001) and was inversely associated with NAFLD remission with a fully adjusted odds ratio (OR) of 0.28 (0.16-0.48) (p trend < 0.001). In a multiple stepwise logistic regression model, circulating adipsin independently predicted NAFLD remission (OR: 0.284, 95% confidence interval [CI]: 0.172-0.471, p for trend <0.001). The area under the receiver operating characteristic curve was 0.751 (95% CI: 0.717-0.785) (p < 0.001) for the prediction model of NAFLD remission.

CONCLUSIONS: We provide evidence for an association between serum adipsin levels and the remission of NAFLD in a community-based prospective cohort study. Serum adipsin can be a potential biomarker for predicting NAFLD remission.

PMID:34814152 | DOI:10.1159/000520368

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Effects of Medium Cutoff Membranes on Pro-Inflammatory Cytokine and Oxidative Marker Levels in Patients with Sepsis Who Developed Acute Kidney Injury

Blood Purif. 2021 Nov 23:1-8. doi: 10.1159/000519881. Online ahead of print.

ABSTRACT

INTRODUCTION: There is insufficient data on the role of the medium cutoff (MCO) membranes in the clearance of pro-inflammatory cytokines and oxidant radicals in patients with sepsis requiring hemodialysis.

METHODS: The study consisted of 38 septic patients who developed acute kidney injury (AKI) and who were scheduled to undergo 2 sessions of hemodialysis. Nineteen patients underwent their first dialysis session with the MCO membrane and 19 patients with the high-flux (HF) membrane. In the second session, the membranes were switched. Pro-inflammatory cytokine and oxidative marker levels were measured in blood samples obtained before and after both dialysis sessions. Reduction ratios were compared for the 2 types of hemodialysis membranes.

RESULTS: After the first session, there was a greater reduction in tumor necrosis factor (TNF)-α with the MCO membrane (28.2 ± 21.1 vs. 8.0 ± 6.6, p = 0.001). After the second session, there was a greater reduction in interleukin (IL)-6 (27.8 ± 26.5 vs. 5.9 ± 13.3, p = 0.003) and IL-1β (20.5 ± 21.1 vs. 4.0 ± 6.5, p = 0.004) with the MCO membrane. When the first and second sessions of all 38 patients were compared, the reductions in TNF-α, IL-6, and IL-1β were consistently greater for MCO than HF (p = 0.001, p = 0.006, p < 0.001, respectively). The reductions in total antioxidant status, total oxidant status, and myeloperoxidase were not statistically different for the 2 types of dialysis membranes.

CONCLUSIONS: MCO membrane was superior to HF membrane in the removal of cytokines in septic patients with AKI. However, a similar effect was not observed for oxidative stress markers.

PMID:34814149 | DOI:10.1159/000519881

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Soluble fluoride in Na2FPO3/CaCO3-based toothpaste as an indicator of systemically bioavailable fluoride

Caries Res. 2021 Nov 23. doi: 10.1159/000521068. Online ahead of print.

ABSTRACT

Fluoride chemically soluble in toothpaste is an indicator of fluoride bioavailability when the teeth are brushed and the same should be expected systemically when toothpaste is ingested. A four-phases study was conducted, in which eight participants were subjected in each phase to one of the assigned treatment groups: Group I: fresh sample of a Na2FPO3/CaCO3 toothpaste with 1,334 μg F/g of total soluble fluoride (TSF); groups II-IV: aged samples of toothpaste presenting TSF concentrations of 1,128, 808, and 687 μg F/g, respectively. In all phases, the participants ingested an amount of toothpaste equivalent to 70.0 µg F/kg body weight, as total fluoride (TF). Blood was collected before (baseline) and up to 180 min after toothpaste ingestion as indicator of fluoride bioavailability. Total urine (24 h before and 24 h after ingestion) was collected as indicator of absorbed fluoride that was excreted. F concentration in blood plasma and urine was determined with a fluoride ion-specific electrode. The areas under the curve of F concentration vs. time (AUC=ng F/ml x min) and the peaks of fluoride concentration in blood plasma (Cmax) were calculated. The net amount of fluoride excreted (mg/day) was calculated by subtraction. A significant correlation of the amount (mg) of TSF ingested was found between the AUC (r= 0.76; p<0.01) and Cmax (r= 0.86; p<0.01) in plasma, and the fluoride excreted (r= 0.65; p<0.01). For TF no statistical correlations were found (p>0.05). Data suggest that the concentration of TSF found in Na2FPO3/CaCO3-based toothpastes is a useful predictor of how much fluoride will be systemically bioavailable when this type of formulation is ingested.

PMID:34814135 | DOI:10.1159/000521068

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Kawasaki Disease and Atopic Diseases: A Systematic Review and Meta-Analysis of Observational Studies

Int Arch Allergy Immunol. 2021 Nov 23:1-9. doi: 10.1159/000520045. Online ahead of print.

ABSTRACT

INTRODUCTION: The etiology of Kawasaki disease (KD), an inflammatory and cardiovascular disorder, remains largely unexplained after more than 50 years of intensive research. In recent years, the association between KD and atopic diseases had been explored by some observational studies. We systematically reviewed and summarized the literature on the relationship between KD and atopic diseases.

METHODS: MEDLINE and EMBASE were searched to identify observational studies on the association between KD and atopic diseases from inception to May 2021. Odds ratio (OR) was pooled using random-effects models. Heterogeneity was assessed using the I2 and Cochran Q statistics. Primary outcomes were to compare the prevalence of KD among individuals with atopic diseases to nonatopic disease controls and the prevalence of atopic diseases among individuals with KD to non-KD controls.

RESULTS: Thirteen studies, including 12,651 cases and 170,708 controls, were included in this meta-analysis. In cross-sectional studies, KD was associated with allergic rhinitis (n = 6; OR, 1.69; 95% CI, 1.52-1.87), asthma (n = 3; OR, 1.72; 95% CI, 1.38-2.14), allergic conjunctivitis (n = 2; OR, 1.95; 95% CI, 1.68-2.27), and atopic dermatitis (n = 3; OR, 1.35; 95% CI, 1.22-1.49). In case-control and cohort studies, KD was associated with allergic rhinitis (n = 3; OR, 1.35; 95% CI, 1.28-1.43), asthma (n = 8; OR, 1.40; 95% CI, 1.19-1.65), allergic conjunctivitis (n = 1; OR, 1.74; 95% CI, 1.45-2.09), and atopic dermatitis (n = 3; OR, 1.39; 95% CI, 1.26-1.53).

CONCLUSION: KD diagnosed was associated with four common atopic diseases. Among the four allergic diseases, allergic conjunctivitis and asthma have the highest correlation with KD, which may provide a direction for exploring the etiology of KD.

PMID:34814144 | DOI:10.1159/000520045

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Correlation between radiographic and pathologic lymph node involvement and extranodal extension via CT and PET in HPV-associated oropharyngeal cancer

Oral Oncol. 2021 Nov 20;123:105625. doi: 10.1016/j.oraloncology.2021.105625. Online ahead of print.

ABSTRACT

PURPOSE/OBJECTIVES: Extranodal extension (ENE) and more than 4 pathologically involved lymph nodes (pN2) are critical prognostic factors in HPV-associated oropharyngeal cancer (HPV(+) OPSCC). We analyze a patient cohort with HPV(+) OPSCC to determine the sensitivity and specificity of CT and PET/CT in identifying involvement of more than 4 lymph nodes (rN2) compared to pN2 and radiographic ENE (rENE) compared to pathologic ENE (pENE).

MATERIALS/METHODS: The dataset consisted of 261 patients enrolled in two prospective clinical trials. All imaging studies were independently reviewed by a blinded neuroradiologist, classifying the presence or absence of rENE and rN2. Secondary analyses included correlations of imaging accuracy and pathologic size of the primary tumor.

RESULTS: CT demonstrated sensitivity of 59%, specificity of 92%, positive predictive value (PPV) of 53%, negative predictive value (NPV) of 94%, and accuracy of 88% for pN2. PET/CT showed similar results. Patients with up to 4 involved lymph nodes (rN0-1) had a 93-94% chance of remaining pN0-1. CT and PET/CT identified an equal number of involved nodes in 81% of patients. CT demonstrated sensitivity of 54%, specificity of 71%, PPV of 72%, NPV of 53%, and accuracy of 62% for pENE. PET/CT showed similar outcomes. Notably, when multiple radiographic criteria were used to identify rENE, PPV increased for both CT (84%) and PET/CT (79%).

CONCLUSION: Patients with rN0-1 had a 93-94% chance of remaining pN0-1, suggesting rN0-1 could effectively stratify patients for clinical trials and treatment de-escalation. While CT and PET/CT were highly correlated, both showed low sensitivity for identifying pENE.

PMID:34814068 | DOI:10.1016/j.oraloncology.2021.105625