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Journal of Personalized Medicine Apr 2021Intravenous ports serve as vascular access and are indispensable in cancer treatment. Most studies are not based on a systematic and standardized approach. Hence, the...
Intravenous ports serve as vascular access and are indispensable in cancer treatment. Most studies are not based on a systematic and standardized approach. Hence, the aim of this study was to demonstrate long-term results of port implantation following a standard algorithm. A total of 2950 patients who underwent intravenous port implantation between March 2012 and December 2018 were included. Data of patients managed following a standard algorithm were analyzed for safety and long-term outcomes. The cephalic vein was the predominant choice of entry vessel. In female patients, wire assistance without use of puncture sheath was less likely and echo-guided puncture via internal jugular vein (IJV) with use of puncture sheath was more likely to be performed, compared to male patients ( < 0.0001). The procedure-related complication rate was 0.07%, and no pneumothorax, hematoma, catheter kinking, catheter fracture, or pocket erosion was reported. Catheter implantations by echo-guided puncture via IJV notably declined from 4.67% to 0.99% ( = 0.027). Mean operative time gradually declined from 37.88 min in 2012 to 23.20 min in 2018. The proposed standard algorithm for port implantation reduced the need for IJV echo-guided approach and eliminated procedure-related catastrophic complications. In addition, it shortened operative time and demonstrated good functional results.
PubMed: 33923312
DOI: 10.3390/jpm11050344 -
The Science of the Total Environment Jan 2023Procida Island, located in the Gulf of Naples (southern Italy), is characterized by steep cliffed coasts, articulated in a succession of headlands and small embayments...
Procida Island, located in the Gulf of Naples (southern Italy), is characterized by steep cliffed coasts, articulated in a succession of headlands and small embayments with narrow pocket beaches, such as Ciraccio and Chiaia, often characterized by instability. In this study, a methodology for coastal cliff susceptibility assessment has been conceived based on hydraulic and geomorphological characteristics, which supported the construction of a Cliff Stability Index (CSI). The geomorphological characteristics are related to the whole cliff face, the cliff material resistance, and the cliff failure mechanisms. The hydraulic actions on the cliff are related to the wave impact which is exerted by the breaking waves once the wave run-up distance exceeds the beach width. The index takes into account the slope of the cliff, the rock strength, the wave energy at the cliff base produced by the broken wave and the presence of defence structures at the cliff base. The resulting index classification, obtained by addition of the partial sub-indices, has been compared with the observed coastal cliff evolution from 1954 to 2021.
Topics: Italy; Conservation of Natural Resources
PubMed: 36122713
DOI: 10.1016/j.scitotenv.2022.158759 -
Neuromodulation : Journal of the... Aug 2021Subcutaneous trigeminal nerve field stimulation (sTNFS) is a neuromodulatory treatment for neuropathic trigeminal pain with the ability to reduce the intensity and...
INTRODUCTION
Subcutaneous trigeminal nerve field stimulation (sTNFS) is a neuromodulatory treatment for neuropathic trigeminal pain with the ability to reduce the intensity and frequency of pain attacks. However, hardware issues including lead migration, skin erosion, infection, so-called pocket pain at the site of the implanted neurostimulator are reported. Implantable wireless neurostimulation technology promises not only an even less invasive sTNFS treatment and thinner and more flexible electrodes better suited for facial implants, but also provides further advantages such as lack of an implantable neurostimulator and 3T magnetic resonance imaging compatibility.
MATERIAL AND METHODS
All patients who had received trial stimulation with a partially implantable sTNFS system were analyzed for ICHD-3 (3rd edition of the International Classification of Headache Disorders) diagnosis, success of trial stimulation, pre- and postoperative pain intensity, frequency of attacks, complications, and side-effects of sTNFS.
RESULTS
All patients (N = 3) responded to sTNFS (≥50% pain reduction) during the trial period. According to ICHD-3, N = 2 of the patients were classified with trigeminal neuralgia (TN) with concomitant persistent facial pain and N = 1 patient with multiple sclerosis associated TN. The time of the test period was 44 ± 31.24 days (mean ± SD). The average daily duration of stimulation per patient amounted 2.5 ± 2.2 hours (range 1-5). The pain intensity (defined on a visual analog scale) was reduced by 80% ± 17% (mean ± SD). Reduction or cessation in pain medication was observed in all patients. No surgical complications occurred in the long-term follow-up period of 18.84 ± 6 (mean ± SD) months.
CONCLUSION
The partially implantable sTNFS device seems to be safe, effective, and reliable. Compared to conventional devices, the equipment is not limited to the length of trial stimulation. Furthermore, the daily stimulation duration was much shorter compared to previous reports.
Topics: Electric Stimulation Therapy; Electrodes, Implanted; Humans; Pain, Intractable; Treatment Outcome; Trigeminal Nerve
PubMed: 34313358
DOI: 10.1111/ner.13478 -
BMC Ophthalmology Jul 2020This report serves to describe the use of a novel adjustable single 8-0 polypropylene suture for scleral fixation without conjunctival dissection, and to describe...
BACKGROUND
This report serves to describe the use of a novel adjustable single 8-0 polypropylene suture for scleral fixation without conjunctival dissection, and to describe related clinical outcomes associated with this approach.
METHODS
In this study, we retrospectively reviewed 28 eyes from 27 patients that underwent scleral fixation of the intraocular lens (IOL) without conjunctival dissection using an adjustable single 8-0 polypropylene suture at the Beijing Tongren Eye Center between April 2018 and April 2019. For this surgical approach, a 23-gauge infusion cannula was set, after which two Hoffmann scleral pockets were created. Next, 8-0 polypropylene sutures were inserted into the eye guided by 10-0 polypropylene sutures of a long straight needle. The 8-0 suture was then used to fix the haptic IOs. Finally, these 8-0 polypropylene sutures were removed from the scleral pockets, and knots were tightened with the adjustable single suture. Primary outcomes included visual acuity and postoperative complication incidence.
RESULTS
For this study, outcomes for 28 eyes from 27 patients (9 female, 18 male) were assessed. Patients had a mean age of 54 ± 15.11 years-old and were followed for an average of 10.18 ± 2.76 months postoperatively. Uncorrected visual acuity in these patients improved significantly from a preoperative value of 1.269 ± 0.464 logMAR to a 3-month postoperative value of 0.409 ± 0.413 logMAR (p = 0.000). The majority of postoperative complications in these patients were temporary and self-limiting, including corneal edema (35.71%), hypotony (14.29%), elevated intraocular pressure (28.58%), and mild hyphema (7.14%). No evidence of exposure or erosion of the trimmed suture end was detected in any patients. An ultrasound biomicroscope was able to readily detect the IOL and all sutures, and IOLs were found to be well-centered without any dislocation, tilting, or subluxation upon follow-up.
CONCLUSIONS
An adjustable single 8-0 polypropylene suture can reliably and effectively be used for scleral fixation without conjunctival dissection for the treatment of patients with aphakia or inadequate posterior capsule support. The novel procedure described herein may therefore be an effective means of minimizing the risk of suture-related complications in patients undergoing scleral-fixated IOL implantation.
TRIAL REGISTRATION
Retrospective case series study, not applicable. NCT04476264 .
Topics: Adult; Aged; Beijing; Dissection; Female; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Male; Middle Aged; Polypropylenes; Postoperative Complications; Retrospective Studies; Sclera; Suture Techniques; Sutures
PubMed: 32711502
DOI: 10.1186/s12886-020-01558-y -
Clinical and Experimental Dermatology Oct 2023Epidermal growth factor receptor inhibitors (EGFRIs) are widely used to treat various types of malignancies. One of the common adverse reactions is cutaneous toxicity,...
Epidermal growth factor receptor inhibitors (EGFRIs) are widely used to treat various types of malignancies. One of the common adverse reactions is cutaneous toxicity, mostly presenting as acneiform eruptions, paronychia and xerosis. Erosive pustular dermatosis of the scalp (EPDS) is a rare cutaneous adverse reaction that develops during treatment with EGFRIs. The pathogenesis of EGFRI-induced EPDS is poorly understood. Here we present three cases of EPDS induced by EGFRIs. The proteins LTA4H (leukotriene A-4 hydrolase), METAP1 (methionine aminopeptidase 1), BID (BH3-interacting domain death agonist), SMAD1 (mothers against decapentaplegic homologue), PRKRA (interferon-inducible double-stranded RNA-dependent protein kinase activator A), YES1 (tyrosine-protein kinase Yes) and EGFL7 (epidermal growth factor-like protein 7) were significantly upregulated in EGFRI-stimulated peripheral blood mononuclear cell cultures, and validated in the lesions. All of the proteins colocalized with CD4+ and CD8+ T-cell expression. Next-generation-based human leucocyte antigen (HLA) typing showed all patients carried HLA-C*15:02, and modelling studies showed that afatinib and erlotinib bound well within the E/F binding pockets of HLA-C*15:02. Moreover, T cells were preferentially activated by EGFRIs in individuals carrying HLA-C*15:02. The case series revealed that EGFRI-induced EPDS may be mediated by drug-specific T cells.
Topics: Humans; Scalp; HLA-C Antigens; Leukocytes, Mononuclear; Skin Diseases; Exanthema; ErbB Receptors; Aminopeptidases; Calcium-Binding Proteins; EGF Family of Proteins
PubMed: 37710038
DOI: 10.1093/ced/llad282 -
Acta Biochimica Et Biophysica Sinica May 2024Rheumatoid arthritis (RA) is an idiopathic and chronic autoimmune disease for which there are currently no effective treatments. Oxypeucedanin hydrate (OXH) is a natural...
Rheumatoid arthritis (RA) is an idiopathic and chronic autoimmune disease for which there are currently no effective treatments. Oxypeucedanin hydrate (OXH) is a natural coumarin known for its potent anti-inflammatory properties. However, further investigations are needed to determine its therapeutic efficacy in treating RA. In this study, we evaluate the anti-inflammatory activity of OXH by treating LPS-induced RAW264.7 macrophages. Our results show that OXH treatment reverses the changes in iNOS, COX-2, IL-1β, IL-6, and TNF-α levels. Additionally, OXH reduces ROS production. Further analysis reveals that OXH suppresses the activation of the NF-κB/MAPK pathway. CETSA results show that OXH competes with LPS for binding to the TLR4/MD2 complex. MST experiments demonstrate the specific affinity of OXH for the TLR4/MD2 complex, with a Kd value of 33.7 μM. Molecular docking analysis suggests that OXH binds to the pocket of the TLR4/MD2 complex and interacts with specific amino acids, such as GLY-343, LYS-388, and PHE-345. Molecular dynamics simulations further confirm this conclusion. Finally, we investigate the potential of OXH in treating RA using a collagen-induced arthritis (CIA) model in rats. OXH effectively ameliorates the symptoms of CIA, including improving body weight, reducing swelling and redness, increasing talus volume, and decreasing bone erosion. OXH also decreases the mRNA levels of pro-inflammatory factors in synovial tissue. Transcriptome enrichment analysis and western blot analysis confirm that OXH suppresses the NF-κB/MAPK pathway, which is consistent with our findings.
PubMed: 38734936
DOI: 10.3724/abbs.2024076 -
Bioorganic & Medicinal Chemistry Dec 2023Bromodomain and PHD finger-containing (BRPF) proteins function as epigenetic readers that specifically recognize acetylated lysine residues on histone tails. The...
Bromodomain and PHD finger-containing (BRPF) proteins function as epigenetic readers that specifically recognize acetylated lysine residues on histone tails. The acetyl-lysine binding pocket of BRPF has emerged as an attractive target for the development of protein interaction inhibitors owing to its potential druggability. In this study, we identified 3-acetylindoles as bone antiresorptive agents with a novel scaffold by performing structure-based virtual screening and hit optimization. Among those derivatives, compound 18 exhibited potent and selective inhibitory activities against BRPF1B (IC = 102 nM) as well as outstanding inhibitory activity against osteoclastogenesis (73.8% @ 1 μM) and differentiation (IC = 0.19 μM) without cytotoxicity. Besides, cellular mechanism assays demonstrated that compound 18 exhibited a strong bone antiresorptive effect by modulating the RANKL/RANK/NFATc1 pathway. Structural and functional studies on BRPF1 inhibitors aid in making advances to understand the epigenetic mechanisms of bone cell development and create innovative therapeutics for treating bone metastases from solid tumors and other bone erosive diseases.
Topics: Osteogenesis; Osteoclasts; NF-kappa B; Receptor Activator of Nuclear Factor-kappa B; Bone Density Conservation Agents; Ligands; Lysine; Cell Differentiation; RANK Ligand; NFATC Transcription Factors
PubMed: 37951134
DOI: 10.1016/j.bmc.2023.117440 -
British Dental Journal Oct 2019Aims To determine patient awareness of periodontal health, dentine hypersensitivity and tooth wear, and their impact on oral health quality of life in patients attending...
Aims To determine patient awareness of periodontal health, dentine hypersensitivity and tooth wear, and their impact on oral health quality of life in patients attending NHS practices in South West England.Method In this cross-sectional, multi-centre epidemiological study 814 adult NHS patients completed an oral health questionnaire and then underwent a clinical examination. Pocket probing depths (mm), gingival recession (mm), gingival bleeding (yes/no), dentine hypersensitivity (Schiff score, and yes/no) and tooth wear (basic erosive wear examination score) were measured.Results Participants were regular dental attenders, with good oral hygiene practices and a low prevalence of periodontal disease (probing depth of 4 mm or more) (25%). For all conditions assessed, self-reported data and clinical indices were significantly positively associated, with the strongest associations being seen for dentine hypersensitivity and the weakest for tooth wear. Periodontal disease and dentine hypersensitivity were significantly associated with all four patient-reported measures of oral health quality of life studied.Conclusion This NHS patient population is well cared for and educated with respect to their oral health. The findings confirm the negative impact of periodontal disease and dentine hypersensitivity, and identifies the need to increase awareness of the signs and symptoms of tooth wear.
Topics: Adult; Cross-Sectional Studies; Dentin Sensitivity; England; Humans; Quality of Life; State Medicine
PubMed: 31605067
DOI: 10.1038/s41415-019-0721-9 -
The International Journal of... 2022To evaluate biologic and esthetic outcomes, as well as the patient-reported outcome measures (PROMs), of full-mouth rehabilitations in patients suffering from...
Biological outcomes and patient-reported outcome measures (PROMs) of minimally invasive full-mouth rehabilitations of patients with erosions and/or abrasions by means of the "3-step technique": part 2 of the 6-year outcomes of a retrospective clinical study.
PURPOSE
To evaluate biologic and esthetic outcomes, as well as the patient-reported outcome measures (PROMs), of full-mouth rehabilitations in patients suffering from generalized erosive and/or abrasive tooth wear following the 3-step technique.
MATERIALS AND METHODS
Patients who received a minimally invasive full-mouth rehabilitation according to the 3-step technique and who were treated at the University of Geneva and/or in a private practice were considered for inclusion. The minimum service time of the restorations was 12 months. The biologic outcomes were analyzed by assessing pocket probing depth (PPD), Plaque Index (PI), and bleeding on probing (BOP). Furthermore, secondary caries, tooth vitality, and sensitivity to temperature were evaluated using the modified United States Public Health Service (USPHS) criteria. The esthetic outcomes were rated with the White Esthetic Score (WES). Finally, PROMs were evaluated using visual analog scales (VAS).
RESULTS
A total of 19 patients with 406 restorations (149 direct composite resins, 110 indirect composite resin/ceramic onlays, and 147 composite resin/ceramic veneers) were examined after a mean follow-up of 71.8 ± 28.6 months. Periodontal parameters were good (mPPD = 2.9 ± 0.4; mPI = 0.1 ± 0.2; and mBOP = 0.05 ± 0.1). No secondary caries were found, and no abutment tooth had lost vitality. A total of 36 abutment teeth had moderate sensitivity, but none presented pronounced sensitivity. The rehabilitations exhibited good esthetic outcomes (mWES = 8.4 ± 1.9). Patients reported satisfying esthetic results of their rehabilitations (mean VAS = 9.2 ± 1.6) and considered their treatment as comfortable (mean VAS = 8.2 ± 2.1), while the least favorably rated parameter was the cost of treatment (mean VAS = 4.1 ± 3.2).
CONCLUSION
Minimally invasive full-mouth rehabilitations of patients with generalized tooth wear by means of the 3-step technique exhibit very good clinical medium-term results with respect to biologic and objective/subjective esthetic outcomes. The patient satisfaction with this treatment was high.
Topics: Biological Products; Composite Resins; Dental Porcelain; Humans; Mouth Rehabilitation; Patient Reported Outcome Measures; Retrospective Studies; Tooth Wear
PubMed: 33871489
DOI: 10.11607/ijp.7248 -
Arquivos Brasileiros de Cirurgia... 2024Bariatric surgery can cause oral health problems in individuals, such as an increase in dental caries, periodontal diseases and dental erosion, which can be avoided if... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Bariatric surgery can cause oral health problems in individuals, such as an increase in dental caries, periodontal diseases and dental erosion, which can be avoided if oral health promotion actions are implemented.
AIMS
To assess the impact of an oral health promotion program implemented among gastroplasty patients.
METHODS
This randomized clinical trial involved 208 patients undergoing gastroplasty; they were divided into two groups: Intervention Group, with participation in the Oral Health Promotion Program for Bariatric Patients, or Control Group. Assessments were carried out preoperatively, and six and 12 months postoperatively. The oral conditions assessed were: dental caries, periodontal diseases, tooth wear, dental plaque, and salivary flow. Sociodemographic information was obtained through application of structured questionnaires. For data analysis, the Chi-Square, Fisher's Exact, and Mann-Whitney tests were performed - α=5%.
RESULTS
Patients in the Intervention Group, when compared to those in the Control Group, presented: fewer changes in enamel (6M: p<0.0001; 12M: p=0.001), in dentin (6M: p<0.0001; 12M: p<0.0001), moderate tooth wear (6M=0.002; 12M=0.005), gingival bleeding (6M: p<0.0001), dental calculus (6M=0.002; 12M: p=0.03), periodontal pocket 4-5 mm (6M=0.001; 12M: p=<0.0001); greater reduction in the bacterial plaque index (6M: p<0.0001; 12M: p<0.0001), and increased salivary flow (6M: p=0.019).
CONCLUSIONS
The oral health promotion program had a positive impact on the prevention and control of the main problems to the oral health of the gastroplasty patients.
Topics: Humans; Male; Oral Health; Female; Gastroplasty; Middle Aged; Adult; Health Promotion
PubMed: 38896700
DOI: 10.1590/0102-6720202400011e1804