Evaluation of soft tissue and labial plate of bone stability with immediate implant in direct contact versus gap with socket shield: A randomized clinical trial with 1 year follow‐up

alexandrossfakianakis shared this article with you from Inoreader Evaluation of soft tissue and labial plate of bone stability with immediate implant in direct contact versus gap with socket shield: A randomized clinical trial with 1 year follow‐up via Clinical Implant Dentistry and Related Research Abstract Objective In the anterior region, the resorption of the buccal plate of bone after tooth extraction leads to contraction of the overlying soft tissues, resulting in an esthetic problem. In the socket shield technique, the buccal root section of the tooth is maintained, to preserve the buccal bone for immediate implant placement. The aim of this randomized clinical trial was to investigate the effect of leaving a gap or not between implant and retained root fragment on bone dimensions and soft tissue esthetics. Methods This was a two armed parallel group randomized clinical trial with allocation ratio 1:1. Patients were eligible in case they needed immediate implant replacing teeth in esthetic zone with sufficient buccal bone support. CBCT was performed immediately after the intervention and 12 months later. Results Forty six patients (26 females and 20 males) were enrolled in the study with 23 of them placed in contact with shield and 23 were placed palatal leaving a gap to graft with a xenograft. After 12 months, excellent soft tissue stability was reported (mean pink esthetic score at placement group A: 12.00 ± 1.60 after 12 months 12.90 ± 1.69, group B 12.62 ± 2.07 and after 12 months 12.38 ± 2.20) Using both surgical techniques. Radiographic crestal bone level changes mean for group A was −0.26 ± 0.52 and for group B -0.34 ± 0.31. There was a strong positive correlation between clinical and radiographic bone width values which was statistically significant (r = 0.782, p < 0.001). Width and thickness of keratinized gingiva showed no significant difference between values measured in both groups. Nonsignificant difference between studied groups according to the labial plate of bone clinical and radiographic changes after i mmediate implantation. Conclusion Within the limitations of this study, the present data seem to support that the clinical outcome of the socket shield technique with immediate implant placement placed in contact or leaving a gap gave excellent esthetic results. View on Web

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Inflammatory and oxidative stress markers in intracerebral hemorrhage: Relevance as prognostic markers for quantification of the edema volume

alexandrossfakianakis shared this article with you from Inoreader Inflammatory and oxidative stress markers in intracerebral hemorrhage: Relevance as prognostic markers for quantification of the edema volume via Brain Pathology The complex formation of post-ICH brain edema. Abstract We aimed to analyze the inflammatory and oxidative stress (OS) markers after intracerebral hemorrhage (ICH) and their temporal changes, interaction effects, and prognostic values as biomarkers for the prediction of the edema volume. Our prospective, longitudinal study included a cohort group of 73 conservatively treated patients with ICH, without hematoma expansion or intraventricular bleeding, which were initialized with the same treatment and provided with the same in-hospital care during the disease course. Study procedures included multilevel comprehensive analyses of clinical and neuroimaging data, aligned with the exploration of 19 inflammatory and five OS markers. White blood cells (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), neutrophilia, and lymphopenia peaked 3 days post-ICH, and they showed much stronger correlations with clinical and neuroimaging variables, when compared to the admission values. An intricate interplay among inflammatory (WBC , CRP, neutrophils, neutrophil-to-lymphocyte ratio [NLR], interleukin (IL)-6, and IL-10) and OS mechanisms (catalase activity and advanced oxidation protein products [AOPP]) was detected operating 3-days post-ICH, being assessed as relevant for prediction of the edema. The overall results suggested complex pathology of formation of post-ICH edema, via: (A) Not additive, but statistically significant synergistic interactions between CRP-ESR, neutrophils-CRP, and neutrophils-IL-6 as drivers for the edema formation; (B) Significant antagonistic effect of high protein oxidation on the CRP-edema dependence, suggesting a mechanism of potential OS-CRP negative feedback loop and redox inactivation of CRP. The final multiple regression model separated the third-day variables NLR, CRP × AOPP, and WBC, as significant prognostic biomarkers for the prediction of the edema volume, with NLR being associated with the highest effect size. Our developed mathematical equation with 3D modeling for prediction and quantification of the edema volume might be beneficial for taking timely adequate strategies for prevention of delayed neurological deteriorations. View on Web

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Differences in levothyroxine action on thyroid autoimmunity and hypothalamic–pituitary–thyroid axis activity between metformin‐ and myo‐inositol‐treated women with autoimmune subclinical hypothyroidism

alexandrossfakianakis shared this article with you from Inoreader Differences in levothyroxine action on thyroid autoimmunity and hypothalamic–pituitary–thyroid axis activity between metformin‐ and myo‐inositol‐treated women with autoimmune subclinical hypothyroidism via Journal of Clinical Pharmacy and Therapeutics The impact of levothyroxine on thyroid antibody titers, thyrotropin, free thyroxine and free triiodothyronine is more pronounced in women with autoimmune subclinical hypothyroidism receiving metformin than myo-inositol. Abstract What is known and objective Insulin resistance impairs the impact of levothyroxine on thyroid autoimmunity and hypothalamic–pituitary–thyroid axis activity. Both metformin and myo-inositol were found to improve insulin sensitivity and to reduce thyrotropin levels in individuals with hypothyroidism. The aim of the present study was to compare the effect of levothyroxine on thyroid autoimmunity and hypothalamic–pituitary–thyroid axis activity between women receiving metformin and myo-inositol. Methods The study included two groups of women with autoimmune hypothyroidism, treated for at least 6 months with either metformin (group A; n = 25) or myo-inositol (group B; n = 25). Both groups were matched for age, insulin sensitivity, hormone levels and antibody titers. For the following 6 months, all women received levothyroxine. Plasma levels of glucose, insulin, thyrotropin, free thyroid hormones, prolactin, 25-hydroxyvitamin D and high-sensitivity C-reactive protein (hsCRP), as well as titers of thyroid peroxidase and thyroglobulin antibodies were assessed at the beginning and at the end of the study. Results and discussion At baseline there were not differences between the study groups. Although levothyroxine reduced thyrotropin levels, increased free thyroid hormone levels and decreased antibody titers in both study groups, these effects were more pronounced in group A than group B. Only in group A, levothyroxine increased 25-hydroxyvitamin D, decreased hsCRP and improved insulin sensitivity. The impact of levothyroxine on thyrotropin and free thyroid hormones correlated with treatment-induced changes in insulin sensitivity, antibody titers, 25-hydroxyvitamin D and hsCRP. What is new and conclusion The present study suggests that the impact of levothyroxine on thyroid autoimmunity and hypothalamic–pituitary–thyroid axis activity is stronger in women receiving metformin than in women treated with myo-inositol. View on Web

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The diagnostic and prognostic value of serum exosome‐derived carbamoyl phosphate synthase 1 in HEV‐related acute liver failure patients

alexandrossfakianakis shared this article with you from Inoreader The diagnostic and prognostic value of serum exosome‐derived carbamoyl phosphate synthase 1 in HEV‐related acute liver failure patients via Journal of Medical Virology Abstract Background Early diagnosis and prognosis evaluation are of great significance to HEV-related acute liver failure (HEV-ALF) patients Methods We collected serum samples from 200 health controls (HCs), 200 patients with acute hepatitis E (AHE) and 200 HEV-ALF patients to evaluate serum exosome-derived carbamoyl phosphate synthase 1 (CPS1) levels and determine its diagnostic and prognostic value. Results The exosome-derived CPS1 levels in the HEV-ALF group were significantly higher than those in the AHE and HCs groups. The AUC of exosome-derived CPS1 to predict the occurrence of HEV-ALF was 0.850 (0.811-0.883). Both logistical regression and orthogonal partial least squares discriminant analysis (OPLS-DA) showed that exosome-derived CPS1 is independent risk factor for HEV-ALF. The exosome-derived CPS1 levels were positively correlated with organ failure, and the outcomes in HEV-ALF patients. The exosome-derived CPS1 levels in the worsening group wer e significantly higher than those in the fluctuating and the improving groups. The AUC of serum exosome-derived CPS1 to predict 30-day mortality was 0.829 (0.770-0.879), which was significantly greater than that of the Child-Pugh, KCH, and MELD model. Conclusions The level of serum exosome-derived CPS1 might serve as promising diagnostic and prognostic biomarker for HEV-ALF patients, which may provide better guidance for the diagnosis, prognosis and treatment of HEV-ALF patients. This article is protected by copyright. All rights reserved. View on Web

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Effect of Somatosensory Interaction Transcutaneous Electrical Acupoint Stimulation on Cancer-related Fatigue and Immunity: A Randomized Controlled Trial

alexandrossfakianakis shared this article with you from Inoreader Effect of Somatosensory Interaction Transcutaneous Electrical Acupoint Stimulation on Cancer-related Fatigue and Immunity: A Randomized Controlled Trial via American Journal of Clinical Oncology - Current Issue Background: This study was intended to evaluate the clinical effect of somatosensory interaction transcutaneous electrical acupoint stimulation (SI-TEAS) on cancer-related fatigue (CRF) and its safety. Methods: The study protocol had been registered in China Clinical Trial Registration Center with registration number: ChiCTR2100045655. CRF patients were equally divided into SI-TEAS Group, Acupressure Group and Sham Acupressure Group to receive SI-TEAS, acupressure and sham acupressure treatments 5 times a week. The fatigue levels of patients in the 3 groups were measured by the Piper Fatigue Scale during the baseline period and after 4 and 8 weeks (of treatment). The cell immunity of these patients was determined by detecting the T-lymphocyte subsets and NK cells. Result: Of the 300 participants, 279 have gone through the independent rehabilitation intervention study, including 94 in the SI-TEAS Group, 92 in the Acupressure Group, and 93 in the Sham Acupressure Group. Intergroup comparisons of fatigue degree and cell immunity, namely SI-TEAS Group versus Acupressure Group, Acupressure Group versus Sham Acupressure Group, and SI-TEAS Group versus Sham Acupressure Group, showed that group changes observed during the baseline period and different time points after Week 4 and 8 were statistically different (P View on Web

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An Exploratory Study of Neoadjuvant Cetuximab Followed by Cetuximab and Chemoradiotherapy in Women With Newly Diagnosed Locally Advanced Cervical Cancer

alexandrossfakianakis shared this article with you from Inoreader An Exploratory Study of Neoadjuvant Cetuximab Followed by Cetuximab and Chemoradiotherapy in Women With Newly Diagnosed Locally Advanced Cervical Cancer via American Journal of Clinical Oncology - Current Issue Objectives: This study explored the feasibility of cetuximab with chemoradiation in women with cervical carcinoma and evaluated fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) to assess early response to cetuximab (NCT00292955). Patients and Methods: Eligible patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB-IVB invasive carcinoma of the uterine cervix were treated on 1 of 3 dose levels (DL). DL1 consisted of neoadjuvant cetuximab, then concurrent radiotherapy with cetuximab 250 mg/m2/cisplatin 40 mg/m2, followed by weekly cetuximab. DL2 consisted of radiotherapy with cetuximab 200 mg/m2 and cisplatin 30 mg/m2. DL3 consisted of radiotherapy with cetuximab 250 mg/m2 and cisplatin 30 mg/m2. Patients underwent 18F-FDG-PET/CT before treatment, after neoadjuvant cetuximab, and at the end of treatment. Results: Of the 21 patients enrolled, 9, 3, and 9 were treated in DL1, DL2, and DL3, respectively. DL1 required dose reductions due to gastrointestinal toxicities. DL2 and 3 were tolerated with 1 dose-limiting toxicity (grade 4 renal failure) at DL3. Following 3 weekly treatments of neoadjuvant cetuximab in DL1, 7 patients had maximum standardized uptake value changes on 18F-FDG-PET/CT consistent with response to cetuximab. Of the 12 patients with locally advanced disease, eleven evaluable patients had no evidence of disease on 18F-FDG-PET/CT at treatment end. Five-year progression-free survival and overall survival rates for all patients were 57.5% and 58.5%, respectively. Conclusions: Cetuximab with cisplatin 30 mg/m2 and radiotherapy was tolerated. 18F-FDG-PET/CT demonstrated early evidence of response to neoadjuvant cetuximab. With advances in precision oncology and the recent approval of pembrolizumab in metastatic cervical cancer, dual-target inhibition with an epidermal growth factor receptor inhibitor may be a promising treatment in the future. View on Web

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Brain metastases: A Society for Neuro-Oncology (SNO) consensus review on current management and future directions

alexandrossfakianakis shared this article with you from Inoreader Brain metastases: A Society for Neuro-Oncology (SNO) consensus review on current management and future directions via Neuro-Oncology Advance Access Abstract Brain metastases occur commonly in patients with advanced solid malignancies. Yet, less is known about brain metastases than cancer-related entities of similar incidence. Advances in oncologic care have heightened the importance of intracranial management. Here, in this consensus review supported by the Society for Neuro-Oncology (SNO), we review the landscape of brain metastases with particular attention to management approaches and ongoing efforts with potential to shape future paradigms of care. Each coauthor carried an area of expertise within the field of brain metastases and initially composed, edited, or reviewed their specific subsection of interest. After each subsection was accordingly written, multiple drafts of the manuscript were circulated to the entire list of authors for group discussion and feedback. The hope is that the these consensus guidelines will accelerate progress in the understanding and management of patients with brain metastases, and highlight key areas in need of further exploration that will lead to dedicated trials and other research investigations designed to advance the field. View on Web

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