COL4A1-related brain small-vessel disease, Intracranial Cortical Calcifications

What is COL4A1 disease?
COL4A1-related brain small-vessel disease is characterized by weakening of the blood vessels in the brain. Stroke is often the first symptom of this condition, typically occurring in mid-adulthood.

What is the COL4A1 gene?
The COL4A1 gene provides instructions for making one component of type IV collagen, which is a flexible protein important in the structure of many tissues throughout the body. Specifically, this gene makes the alpha1(IV) chain of type IV collagen.

Patients with chronic parathyroid dysfunction often have intracranial calcification in deep gray matter (GM) and subcortical white matter

What are the symptoms of brain calcification?
Muscle cramping (dystonia), uncontrollable spasmodic irregular movements (chorea), and seizures can also occur. Occasional symptoms include sensory changes, headaches and urinary incontinence. Associated symptoms include loss of contact with reality (psychosis), mood swings and loss of acquired motor skills.

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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

How we approach the diagnosis of a vascular anomaly

alexandrossfakianakis shared this article with you from Inoreader How we approach the diagnosis of a vascular anomaly via Pediatric Blood & Cancer Abstract Vascular anomalies represent a diverse group of complex disorders that can cause significant complications, including coagulopathies, pain, and decreased function. The diagnosis of vascular anomalies is often challenging due to heterogeneity of presenting phenotypes and overlapping clinical features with other pediatric conditions. Pediatric hematologists/oncologists (PHO) are uniquely positioned for an essential role in diagnosing, managing, and coordinating the multidisciplinary care required to maximize the quality of life of these patients. Here, we review the diagnostic approach involved in patients with vascular anomalies and utilize cases to highlight the challenges involved, and how PHOs can play a vital part in the care of these patients. View on Web

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Assessment of periodontitis grade in epidemiological studies using interdental attachment loss instead of radiographic bone loss

alexandrossfakianakis shared this article with you from Inoreader Assessment of periodontitis grade in epidemiological studies using interdental attachment loss instead of radiographic bone loss via Journal of Clinical Periodontology Abstract Objective Comparison of grading according to radiographic bone loss (BL) or according to interdental clinical attachment loss (CAL). Methods In 100 periodontitis patients of the Department of Periodontology of Goethe-University Frankfurt, Germany periodontitis grade was assigned by i) indirect evidence using BL at the most affected tooth divided by root length and ii) CAL at the most affected tooth divided by root length of the respective tooth type according to root length in German and Swedish cohorts. Resulting quotients were divided by age. Results Patients (age: 53.5±10.4 years; 57 females; 16 smokers; no diabetes; stage 78 III, 22 IV) were by either method assigned to grade B or C (BL: 35 B, 65 C; CAL [German]: 23 B, 77 C; [Swedish]: 29 B, 71 C). Using root length (German cohort), agreement was 76% (kappa: 0.427; fair to good /moderate agreement) and 72% (Swedish cohort; kappa: 0.359; poor agreement/fair). Molars were most frequently chosen (BL: 64%; CAL: 71%). Conclusions Assignment of periodontitis grade by indirect evidence using BL or CAL using standard root length of the German cohort showed fair to good/moderate agreement. Thus, grade assignment by CAL may be used in epidemiologic studies where radiographs are not available. View on Web

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Effects of Artificial Intelligence (AI)‐Assisted Dental Monitoring Intervention in Patients with Periodontitis: A Randomized Controlled Trial

alexandrossfakianakis shared this article with you from Inoreader Effects of Artificial Intelligence (AI)‐Assisted Dental Monitoring Intervention in Patients with Periodontitis: A Randomized Controlled Trial via Journal of Clinical Periodontology Abstract Aim To evaluate the effects of an at-home AI-assisted dental monitoring application on treatment outcomes in patients with periodontitis. Materials and methods Participants with periodontitis were recruited and randomly assigned into an AI (AI; n = 16), AI and human counseling (AIHC; n = 17), or control (CG; n = 20) group. All participants received nonsurgical periodontal treatment. We employed an AI-assisted tool called DENTAL MONITORING® (DM) intervention, a new technological AI monitoring product that utilizes smartphone cameras for intraoral scanning and assessment. Patients in the AI and AIHC groups respectively received additional (a) DM or (b) DM with real-person counseling over three months. Periodontal parameters were collected at baseline and follow-ups. A mixed-design model analyzed the follow-up effects over time. Results The AI and AIHC groups respectively exhibited greater improvement in probing pocket depth [Mean diff = −0.9±0.4 and −1.4±0.3, effect size (ES) = 0.76 and 1.98], clinical attachment level (Mean diff = −0.8±0.3 and −1.4±0.3, ES = 0.84 and 1.77) and plaque index (Mean diff = −0.5±0.2 and −0.7±0.2, ES = 0.93 and 1.81) at 3-month follow-up than the CG did. The AIHC group had a greater reduction in probing pocket depth (ES = 0.46) and clinical attachment level (ES = 0.64) at the 3-month follow-up compared with the AI group. Conclusion Using AI monitoring at home had a positive effect on treatment outcomes for patients with periodontitis. Patients with AI-assisted health counseling exhibited better treatment outcomes than did patients who used AI monitoring alone. This article is protected by copyright. All rights reserved. View on Web

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Soft and hard tissue changes after immediate implant placement with or without a sub‐epithelial connective tissue graft: results from a 6‐months pilot randomized controlled clinical trial

alexandrossfakianakis shared this article with you from Inoreader Soft and hard tissue changes after immediate implant placement with or without a sub‐epithelial connective tissue graft: results from a 6‐months pilot randomized controlled clinical trial via Journal of Clinical Periodontology Abstract Aim The present pilot RCT aimed to investigate the influence of a connective tissue graft (CTG) in combination with the immediate implant placement (IIP) on hard and soft tissues healing, without a bone replacement graft in the gap between the implant and the socket walls. Material and Methods Thirty patients requiring extraction of one anterior tooth (from premolar to premolar) were randomly assigned to one of the two treatment groups (test: IIP+CTG; control: IIP). Cone-beam computed tomography (CBCT) and optically scans were performed before tooth extraction and at 6-months follow-up. Then, DICOM files were superimposed in order to allow the evaluation of osseous ridge and buccal bone changes, while the superimposition of DICOM and STL (Standard Tessellation Language) files allowed for evaluating of soft tissue contour. For testing the differences between the two groups, the non-parametric test as Wilcoxon rank-sum test, was used. Results Twenty-six out of the thirty enrolled patients, attended the 6-month follow-up visit. The 4 patients of control group that were lost to follow-up, were analyzed under the intention-to-treat principle. No statistically significant differences between the groups were observed for the vertical buccal bone resorption (p=0.90), as well as for the horizontal buccal bone resorption at all measured levels. Significant differences were found between test and control groups in the horizontal dimensional changes of osseous ridge at the most coronal aspect (p=0.0003 and p=0.02). Changes of tissue contour ranged between -0.32 and -0.04 mm in the test group, and between -1.94 and -1.08 mm in the control group, while changes of soft tissue thickness varied between 1.33 and 2.42 mm in the test group, and between -0.16 and 0.88 mm in the control group, with statistically significant differences for both variables at all measured levels. At 6 months, the mean volume inc rease was 6.76±8.94 mm3 and 0.16±0.42 mm3 in the test and control groups, respectively, with statistically significant difference. Conclusions The findings of the present study indicate that the adjunct of a connective tissue graft at the time of immediate implant placement, without bone grafting, does not influence vertical bone resorption. Within the limits of the present study, it can be suggested that the adjunct of a connective tissue graft at the time of immediate implant placement, without bone grafting, reduces the horizontal changes of the alveolar ridge. Moreover, it allows maintenance of the tissue contour due to an increase in soft tissue thickness. View on Web

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Long non‐coding RNA SNHG5 mediates periodontal inflammation through the NF‐κB signaling pathway

alexandrossfakianakis shared this article with you from Inoreader Long non‐coding RNA SNHG5 mediates periodontal inflammation through the NF‐κB signaling pathway via Journal of Clinical Periodontology Abstract Aim We investigated the role of the long non-coding RNA (lncRNA), small nucleolar RNA host gene 5 (SNHG5), in the pathogenesis of periodontitis. Materials and methods A ligature-induced periodontitis mouse model was established, and gingival tissues from patients with periodontitis and healthy controls were collected. Inflammatory cytokines were detected using qRT-PCR and western blotting analyses. Direct interactions between SNHG5 and p65 were detected by RNA pull-down and RNA immunoprecipitation assays. Micro-computed tomography, hematoxylin and eosin staining, and immunohistochemical staining were used to measure periodontal bone loss. Results SNHG5 expression was downregulated in human and mouse periodontal tissues compared to that in the healthy controls. In vitro experiments demonstrated that SNHG5 significantly ameliorated tumor necrosis factor-α (TNFα)-induced inflammation. Mechanistically, SNHG5 directly binds to the nuclear factor-kappa B (NF-κB) p65 subunit and inhibits its translocation, thereby suppressing the NF-κB signaling pathway activation and reducing the nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 inflammasome expression. Locally injecting si-SNHG5 aggravated the periodontal destruction. Conclusion This study revealed that SNHG5 mediates periodontal inflammation through the NF-κB signaling pathway, providing a potential therapeutic target for periodontitis treatment. This article is protected by copyright. All rights reserved. View on Web

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Lingual Frenectomy Criteria

The term free-tongue is defined as the length of tongue from the insertion of the lingual frenum into the base of the tongue to the tip of the tongue. Clinically acceptable, normal range of free tongue is greater than 16 mm. 

The ankyloglossia can be classified into 4 classes based on Kotlow's assessment as follows; 

Class I: Mild ankyloglossia: 12 to 16 mm, 

Class II: Moderate ankyloglossia: 8 to 11 mm, 

Class III: Severe ankyloglossia: 3 to 7 mm, 

Class IV: Complete ankyloglossia: Less than 3 mm.2 

Class III and IV tongue-tie category should be given special consideration because they severely restrict the tongue's movement. A normal range of motion of the tongue is indicated by the following criteria: The tip of the tongue should be able to protrude outside the mouth; without clefting, the tip of the tongue should be able to sweep the upper and lower lips easily; without straining, when the tongue is retruded, it should not blanch the tissues lingual to the anterior teeth; and the lingual frenum should not create a diastema between the mandibular central incisors.

Ankyloglossia was also found associated in cases with some rare syndromes such as X-linked cleft palate syndrome, Kindler syndrome, van der Woude syndrome, and Opitz syndrome.Nevertheless, most ankyloglossias are observed in persons without any other congenital anomalies or diseases.

The difficulties in articulation are evident for consonants and sounds like "s, z, t, d, l, j, zh, ch, th, dg" and it is especially difficult to roll an "r".

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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

Effectiveness of Tongue‐tie Assessment Tools in Diagnosing and Fulfilling Lingual Frenectomy Criteria: A Systematic Review

alexandrossfakianakis shared this article with you from Inoreader Effectiveness of Tongue‐tie Assessment Tools in Diagnosing and Fulfilling Lingual Frenectomy Criteria: A Systematic Review via Australian Dental Journal ABSTRACT It is unclear how effective tongue-tie classification assessment tools are in diagnosing symptomatic tongue-tie and fulfilling lingual frenectomy criteria. The purpose of this systematic review is to determine and evaluate any association between tongue-tie severity, as measured by pre-treatment assessment tools, and post-operative outcome following tongue-tie division. PubMed, EMBASE, and the Cochrane search engines were used to retrieve articles published between 1947 and 2021. Included studies consisted of patients with symptomatic tongue-tie, assessment by either the Coryllos, Kotlow, or Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF) classification tool, and tongue-tie division. A total of 205 abstracts were identified; 31 studies met the criteria for a full-text review, of which, only 14 studies met the criteria for data extraction and analysis. Six studies used the HATLFF, 2 studies used the Kotlow, 5 studies used the Coryllos, and 1 study used a combinati on of both Kotlow and Coryllos methods. Significant heterogeneity was evident across all studies. No statistical correlation between the two variables could be determined. Although tongue-tie division procedures appear to provide benefits in breastfeeding and speech, there are no data to suggest a statistically significant association between the severity of tongue-tie, and the correct identification of patients who would benefit from tongue-tie division. © 2022 Australian Dental Association. View on Web

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Effect of three different remineralizing agents on artificial erosive lesions of primary teeth

alexandrossfakianakis shared this article with you from Inoreader Effect of three different remineralizing agents on artificial erosive lesions of primary teeth via Australian Dental Journal ABSTRACT Background This study aimed to investigate the efficacy of three remineralizing agents on dental erosion in primary teeth. Methods Forty primary molars were randomly divided into four groups (n = 10 each): self-assembling peptide (P11-4), casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP), sodium fluoride (NaF), and artificial saliva (AS; control). The erosion-like formation was created by immersing the samples in citric acid (4 × 2 min, pH 2.3) and AS (4 × 2 h, pH 7). The eroded samples were then treated with remineralizing agents and subjected to further erosion consisting of 15 cycles (3x/8-h interval) of immersion in citric acid and AS for 6 s each. Alterations in the mineral content and morphology of the samples were quantified using a microhardness tester and atomic force microscope. Results All agents had a significant remineralization effect on eroded primary tooth enamel. After further erosive challenge, enamel loss in the CPP-ACFP group was found to be significantly lower than in all other groups, and no significant difference was found between the P11-4 and NaF groups. Conclusions This study demonstrated that all tested materials had remineralization ability, and CPP-ACFP had a superior effect in inhibiting enamel loss due to dental erosion in primary teeth. © 2022 Australian Dental Association. View on Web

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Linear IgA bullous dermatosis with desquamative gingivitis: A case report and literature review

alexandrossfakianakis shared this article with you from Inoreader Linear IgA bullous dermatosis with desquamative gingivitis: A case report and literature review via ScienceDirect Publication: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology Publication date: Available online 17 June 2022 Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology Author(s): Kana Kashima, Yoshihiro Morita, Mao Suzuki, Hiroko Kinosada, Yuka Matsumiya-Matsumoto, Itsuro Kato, Kazuhide Matsunaga, Narikazu Uzawa View on Web

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Intraosseous Ameloblastic Fibro-dentinoma an aggressive demeanor in a two-year-old

alexandrossfakianakis shared this article with you from Inoreader Intraosseous Ameloblastic Fibro-dentinoma an aggressive demeanor in a two-year-old via ScienceDirect Publication: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology Publication date: Available online 18 June 2022 Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology Author(s): Pushkar Waknis, Supriya Kheur, Madhura Shekatkar, Kripa Gupta, Luke Kale, Mamatha Reddy View on Web

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Clinical Significance and Molecular Annotation of Cellular Morphometric Subtypes in Lower Grade Gliomas discovered by Machine Learning

alexandrossfakianakis shared this article with you from Inoreader Clinical Significance and Molecular Annotation of Cellular Morphometric Subtypes in Lower Grade Gliomas discovered by Machine Learning via Neuro-Oncology Advance Access Abstract BACKGROUND Lower grade gliomas (LGG) are heterogenous diseases by clinical, histological, and molecular criteria. We aimed to personalize the diagnosis and therapy of LGG patients by developing and validating robust cellular morphometric subtypes (CMS) and to uncover the molecular signatures underlying these subtypes. METHODS Cellular morphometric biomarkers (CMBs) were identified with artificial intelligence technique from TCGA-LGG cohort. Consensus clustering was used to define CMS. Survival analysis was performed to assess the clinical impact of CMBs and CMS. A nomogram was constructed to predict 3- and 5- year overall survival (OS) of LGG patients. Tumor mutational burden (TMB), and immune cell infiltration between subtypes were analyzed using the Mann-Whitney test. The double-blinded validation for important immunotherapy-related biomarkers were executed using immunohistochemistry (IHC). RESULTS We developed a mac hine learning pipeline to extract CMBs from whole slide images of tissue histology; identifying and externally validating robust CMS of LGGs in multi-center cohorts. The subtypes had independent predicted OS across all three independent cohorts. In the TCGA-LGG cohort, patients within the poor-prognosis subtype responded poorly to primary and follow-up therapies. LGGs within the poor-prognosis subtype were characterized by high mutational burden, high frequencies of copy number alterations, and high levels of tumor-infiltrating lymphocytes and immune checkpoint genes. Higher levels of PD-1/PD-L1/CTLA-4 were confirmed by immunohistochemical staining. In addition, the subtypes learned from LGG demonstrates translational impact on glioblastoma (GBM). CONCLUSIONS We developed and validated a framework (CMS-ML) for CMS discovery in LGG associated with specific molecular alterations, immune micro-environment, prognosis, and treatment response. View on Web

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