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Oncology and Therapy Jun 2024Breast cancer presents diverse molecular subtypes affecting treatment strategies. Human epidermal growth factor receptor 2 (HER2)-low, hormone receptor-positive (HR+)...
BACKGROUND
Breast cancer presents diverse molecular subtypes affecting treatment strategies. Human epidermal growth factor receptor 2 (HER2)-low, hormone receptor-positive (HR+) breast cancer poses a challenge due to limited targeted therapies. Current neoadjuvant treatment primarily utilizes chemotherapy, with conflicting results regarding efficacy in patients with HER2-low breast cancer. Trastuzumab deruxtecan (T-DXd) shows promise in HER2-low metastatic disease, and preliminary evidence suggests synergy with endocrine therapy.
OBJECTIVE
This editorial explores the hypothesis that neoadjuvant T-DXd with or without endocrine therapy offers efficacy in the clinical management of HR+/HER2-low breast cancer.
METHODS
We propose a phase II study with two treatment arms: T-DXd + letrozole and T-DXd alone. The primary endpoint is the radiological complete response rate. Secondary endpoints include pathological complete response rate, safety, event-free survival, and overall survival. Exploratory analyses will compare the arms to identify potential for optimizing treatment efficacy and minimizing side effects.
CONCLUSIONS
This study design allows for initial assessment of T-DXd with or without endocrine therapy in the treatment of HER2-low breast cancer. The findings may pave the way for personalized treatment strategies and inform future research, potentially leading to a chemotherapy-sparing approach.
PubMed: 38941050
DOI: 10.1007/s40487-024-00286-3 -
Head and Neck Pathology Jun 2024Previous studies have shown that at least a of intraoral eosinophilic ulcer is best classified as a CD30 + T-cell lymphoproliferative disorder (LPD), with... (Review)
Review
BACKGROUND
Previous studies have shown that at least a of intraoral eosinophilic ulcer is best classified as a CD30 + T-cell lymphoproliferative disorder (LPD), with histopathology reminiscent of lymphomatoid papulosis (LyP) of the skin. Microscopically, a mixed population of inflammatory cells, often including eosinophils and varying numbers of atypical lymphoid cells, frequently expressing CD30, is typical for LyP, whose clinicopathological spectrum includes type A, B, C, D, E, and LyP with DUSP22/IRF4 rearrangement. To date, about 27 intraoral LyP cases have been reported. Of them, 7 cases were diagnosed as LyP type C, which is frequently confused with anaplastic large cell lymphoma (ALCL) on histopathology.
METHODS
A 60-year-old male was referred for a one-month history of a tongue ulcer.
RESULTS
Microscopy showed numerous subepithelial atypical large lymphoid cells, which expressed CD4 (with partial loss of CD3, CD5, and CD7), CD8 (few cells), CD30 (about 50%, in non-diffuse pattern with size variability), TIA-1, and Ki-67 (85%), without staining for CD56, ALK, LMP1, and EBER1/2, concerning for a diagnosis of ALCL. However, after three weeks, the lesion completely healed.
CONCLUSION
We present here a rare case of intraoral CD30+ T-cell LPD that we believe is the oral counterpart of cutaneous LyP type C.
Topics: Humans; Male; Lymphomatoid Papulosis; Middle Aged; Ki-1 Antigen; Diagnosis, Differential; Immunohistochemistry; Lymphoproliferative Disorders; Biomarkers, Tumor; T-Lymphocytes
PubMed: 38941041
DOI: 10.1007/s12105-024-01664-z -
Oral Radiology Jun 2024The objective of this study was to enhance the visibility of soft tissues on cone-beam computed tomography (CBCT) using a CycleGAN network trained on CT images.
OBJECTIVES
The objective of this study was to enhance the visibility of soft tissues on cone-beam computed tomography (CBCT) using a CycleGAN network trained on CT images.
METHODS
Training and evaluation of the CycleGAN were conducted using CT and CBCT images collected from Aichi Gakuin University (α facility) and Osaka Dental University (β facility). Synthesized images (sCBCT) output by the CycleGAN network were evaluated by comparing them with the original images (oCBCT) and CT images, and assessments were made using histogram analysis and human scoring of soft-tissue anatomical structures and cystic lesions.
RESULTS
The histogram analysis showed that on sCBCT, soft-tissue anatomical structures showed significant shifts in voxel intensity toward values resembling those on CT, with the mean values for all structures approaching those of CT and the specialists' visibility scores being significantly increased. However, improvement in the visibility of cystic lesions was limited.
CONCLUSIONS
Image synthesis using CycleGAN significantly improved the visibility of soft tissue on CBCT, with this improvement being particularly notable from the submandibular region to the floor of the mouth. Although the effect on the visibility of cystic lesions was limited, there is potential for further improvement through refinement of the training method.
PubMed: 38941003
DOI: 10.1007/s11282-024-00763-5 -
International Journal of Legal Medicine Jun 2024Cranial vault thickness (CVT) and its variations provide valuable insights into an individual's biological attributes such as age and sex. This paper aimed to assess the...
Cranial vault thickness (CVT) and its variations provide valuable insights into an individual's biological attributes such as age and sex. This paper aimed to assess the correlations of CVT with age and sex and develop a regression model for age estimation in Malaysian subadults using computed tomography (CT) images. A total of 521 CT images (male/female: 279/242; age range: 0-20 years; Malay/Chinese/Indian: 221/145/155) were included in the study. Correlations of CVT measurements with age and sex, including frontal bone thickness (FBT), occipital bone thickness (OBT), left parietal bone thickness (LPBT), and right parietal bone thickness (RPBT) were assessed and regression formulae were developed for age estimation in subadults. A significant correlation between CVT measurements and age was demonstrated (p < 0.001). Age estimation was most accurate in the younger age group (< 2 years) at frontal and occipital, and accuracy decreases in the older age groups. Additionally, sexual dimorphism was evident in the frontal and parietal bone thickness within the age range of 3-6 years and 16-20 years, respectively. In conclusion, the findings suggested CVT measurements could be used to corroborate other age estimation methods for subadults.
PubMed: 38940946
DOI: 10.1007/s00414-024-03276-2 -
Clinical Oral Investigations Jun 2024Evaluate the efficacy of denture cleaners on the adhesion of Candida albicans and their effects on the surface, optical, and mechanical properties of resins for...
OBJECTIVES
Evaluate the efficacy of denture cleaners on the adhesion of Candida albicans and their effects on the surface, optical, and mechanical properties of resins for conventional, milled, and 3D-printed denture bases.
MATERIALS AND METHODS
A total of 240 resin samples were made, 120 for testing Candida albicans adhesion, optical stabilities (ΔE), roughness (Ra), hydrophilicity (°), surface free energy (Owens-Wendt) and 120 samples for testing Candida albicans adhesion, surface microhardness (Knoop), flexural strength and modulus of elasticity in a three-point test, in which they were divided into 3 groups of denture resin (n = 40) and subdivided into 5 cleaners of dentures (n = 8). Data were evaluated by two-way ANOVA and Tukey's test for multiple comparisons (α = 0.05).
RESULTS
Denture cleaners with an alkaline solution and dilute acid composition were those that showed the greatest effectiveness in reducing Candida albicans (P < 0.001), however 1% NaOCl significantly affected the properties of the resins (P < 0.05). Denture 3D-printed showed that the surface microhardness was significantly lower for all cleansers (P < 0.05).
CONCLUSIONS
Listerine demonstrated superior efficacy in reducing Candida albicans with minimal effect on denture properties, whereas 1% NaOCl had a significant negative impact on the properties. The mechanical properties were significantly lower in 3D-printed resin than in other resins for all denture cleansers.
CLINICAL RELEVANCE
Denture base materials are being sold to adapt to the CAD/CAM system, increasing the number of users of dentures manufactured with this system. Despite this, there is little investigation into denture cleaners regarding the adhesion capacity of microorganisms and the optical, surface and mechanical properties of dentures, thus requiring further investigation.
Topics: Candida albicans; Denture Bases; Denture Cleansers; Surface Properties; Printing, Three-Dimensional; Materials Testing; Computer-Aided Design; Hardness; Flexural Strength; Dental Materials
PubMed: 38940942
DOI: 10.1007/s00784-024-05801-4 -
Head and Neck Pathology Jun 2024Myoepithelioma is a benign salivary gland tumor. Central myoepitheliomas are very rare. The aim of this report was to describe a case of maxillary myoepithelioma. A...
Myoepithelioma is a benign salivary gland tumor. Central myoepitheliomas are very rare. The aim of this report was to describe a case of maxillary myoepithelioma. A 14-year-old female patient presented with an multilocular lesion in the anterior maxilla, with nearly 8 months of duration. The lesion was asymptomatic, and the patient's dental history was unremarkable. The diagnostic hypothesis was an odontogenic tumor. Biopsy specimen consisted of nests of plasmacytoid cells in a myxoid stroma without duct formation. No cellular atypia or bone and cartilage formation were noted. The neoplastic cells were positive for Pan-cytokeratin, S100, CK7, and CK8. The final diagnosis was myoepithelioma. The patient was treated by surgical excision followed by bone curettage, and no signs of recurrence were found after 8 years of treatment.
Topics: Humans; Female; Myoepithelioma; Adolescent; Maxillary Neoplasms; Biomarkers, Tumor
PubMed: 38940938
DOI: 10.1007/s12105-024-01665-y -
Diabetologia Jun 2024
Correction: Discovery and validation of plasma, saliva and multi-fluid plasma-saliva metabolomic scores predicting insulin resistance and diabetes progression or regression among Puerto Rican adults.
PubMed: 38940920
DOI: 10.1007/s00125-024-06199-0 -
Clinical Oral Investigations Jun 2024The purpose of this prospective cohort study is to evaluate the effect of peri-implant phenotype (PPh) on the severity of peri-implant diseases and the results of...
OBJECTIVES
The purpose of this prospective cohort study is to evaluate the effect of peri-implant phenotype (PPh) on the severity of peri-implant diseases and the results of non-surgical mechanical treatment (NSMT), along with calprotectin (CLP) and MMP-8(matrix metalloproteinase-8) levels.
MATERIALS AND METHODS
77 implants from 39 patients were included. The implants were categorized Group-1(peri-implant mucositis), Group-2(peri-implantitis).Baseline (0. Month-PrT) clinical parameters (PD, GI, PI, BOP, CAL) and radiographic bone loss were documented, and peri-implant crevicular fluid (PICF) samples were collected. Various intruments and methodologies were employed to assess PPh components (mucosa thickness, supracrestal tissue height, keratinized mucosa) and peri-implant attached mucosa (AM). NSMT was applied to diseased implant sites. All clinical parameters were reassessed again by taking PICF samples at the 6th month-after treatment (PT). In PICF samples obtained from both groups, MMP-8 and CLP levels were evaluated using the ELISA test.
RESULTS
PrT-PD,PrT-GI,PrT-CAL and PrT-BOP percentage values in Group-2 were significantly higher than Group-1.PrT-PD,PrTPI scores are significantly higher in thin biotype implants. All components of the PPh and AM were significantly lower in thin biotype. Intra-group time-dependent changes of MMP-8 and CLP were significant in both groups (p < 0.05). When the relationship between thin and thick biotype and biochemical parameters was evaluated, the change in PrT-PT didn't show a significant difference (p > 0.05).
CONCLUSIONS
PPh plays a role in influencing the severity of peri-implant diseases. However, the impact of phenotype on NSMT outcomes was similar in both groups.
CLINICAL RELEVANCE
The PPh should be considered when planning implant surgery.
Topics: Humans; Matrix Metalloproteinase 8; Female; Prospective Studies; Peri-Implantitis; Male; Middle Aged; Phenotype; Gingival Crevicular Fluid; Leukocyte L1 Antigen Complex; Dental Implants; Enzyme-Linked Immunosorbent Assay; Biomarkers; Stomatitis; Periodontal Index; Adult; Aged
PubMed: 38940878
DOI: 10.1007/s00784-024-05798-w -
Pediatric Cardiology Jun 2024By comparison with adults, cardiopulmonary exercise testing in children with Tetralogy of Fallot is limited, and its clinical application less clarified. This study...
By comparison with adults, cardiopulmonary exercise testing in children with Tetralogy of Fallot is limited, and its clinical application less clarified. This study provides a comprehensive CPET profile in a child-adolescent population with repaired TOF, explores mechanisms underpinning exercise intolerance and associations with clinical outcome. Seventy-four CPETs were completed in 58 child-adolescents with rTOF (age 13.8 SD 2.4 years). CPET parameters were corrected for age, sex and body size. At follow-up (4.9 years, IQR 3.5-7.9) clinical status and re-intervention was evaluated and CPET indices predicting these outcomes determined. Cohort peak V̇O was within low-normal limits (% pred: 74.1% SD 15.4) with 15 patients (26%) displaying moderately severe reduction in V̇O (< 65% pred). Oxygen uptake efficiency slope highly correlated with V̇O (r = 0.94, p < 0.001) and was insensitive to exercise intensity. No significant change in CPET occurred in patients who underwent interval testing at 24 SD 14.5 months, although there was a variable response in V̇O between individuals. Chronotropic response, lung vital capacity, heart rate-V̇O slope (indicator of stroke volume) predicted oxygen consumption: V̇O (R = 50.91%, p < 0.001) and workload (R = 58.39%, p < 0.001). Adverse clinical status was associated with reduced workload (OR 0.97, p = 0.011). V̇/V̇ slope was steeper in those that died ((%pred:137.8 SD 60.5 vs. 108.4 SD 17.0, p < 0.019). RVOT reintervention post-CPET (24 patients, 43.8%) was associated with an increased gradient of HR-VO slope (OR 1.042, p = 0.004). In child-adolescents with TOF important reductions in cardiopulmonary functioning were apparent in 25% of patients. Exercise intolerance was related to reduced vital capacity, impaired chronotropic response and deficient stroke volume increment.
PubMed: 38940827
DOI: 10.1007/s00246-024-03524-7 -
Clinical Implant Dentistry and Related... Jun 2024The aim of this work is to present a new protocol for implant surgical planning which involves the combined use of artificial intelligence (AI) and mixed reality (MR).
AIM
The aim of this work is to present a new protocol for implant surgical planning which involves the combined use of artificial intelligence (AI) and mixed reality (MR).
METHODS
This protocol involves the acquisition of three-dimensional (3D) patient data through intraoral scanning (IOS) and cone beam computed tomography (CBCT). These data are loaded into AI software which automatically segments and aligns the patient's 3D models. These 3D models are loaded into MR software and used for planning implant surgery through holography. The files are then exported and used to design surgical guides via open-source software, which are 3D printed and used to prepare the implant sites through static computer-assisted implant surgery (s-CAIS). The case is finalized prosthetically through a fully digital protocol. The accuracy of implant positioning is verified by comparing the planned position with the actual position of the implants after surgery.
RESULTS
As a proof of principle, the present protocol seems to be to be reliable and efficient when used for planning simple cases of s-CAIS in partially edentulous patients. The clinician can plan the implants in an authentic 3D environment without using any radiology-guided surgery software. The precision of implant placement seems clinically acceptable, with minor deviations.
CONCLUSIONS
The present study suggests that AI and MR technologies can be successfully used in s-CAIS for an authentic 3D planning. Further clinical studies are needed to validate this protocol.
PubMed: 38940681
DOI: 10.1111/cid.13357