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ESC Heart Failure Jul 2024Hospitalizations are common in patients with heart failure and are associated with high mortality, readmission and economic burden. Detecting early signs of worsening...
AIMS
Hospitalizations are common in patients with heart failure and are associated with high mortality, readmission and economic burden. Detecting early signs of worsening heart failure may enable earlier intervention and reduce hospitalizations. The HeartLogic algorithm is designed to predict worsening heart failure using diagnostic data from multiple device sensors. The main objective of this analysis was to evaluate the sensitivity of the HeartLogic alert calculation in predicting worsening heart failure events (HFEs). We also evaluated the false positive alert rate (FPR) and compared the incidence of HFEs occurring in a HeartLogic alert state to those occurring out of an alert state.
METHODS
The HINODE study enrolled 144 patients (81 ICD and 63 CRT-D) with device sensor data transmitted via a remote monitoring system. HeartLogic alerts were then retrospectively simulated using relevant sensor data. Clinicians and patients were blinded to calculated alerts. Reported adverse events with HF symptoms were adjudicated and classified by an independent HFE committee. Sensitivity was defined as the ratio of the number of detected usable HFEs (true positives) to the total number of usable HFEs. A false positive alert was defined as an alert with no usable HFE between the alert onset date and the alert recovery date plus 30 days. The patient follow-up period was categorized as in alert state or out of alert state. The event rate ratio was the HFE rate calculated in alert to out of alert.
RESULTS
The patient cohort was 79% male and had an average age of 68 ± 12 years. This analysis yielded 244 years of follow-up data with 73 HFEs from 37 patients. A total of 311 HeartLogic alerts at the nominal threshold (16) occurred across 106 patients providing an alert rate of 1.27 alerts per patient-year. The HFE rate was 8.4 times greater while in alert compared with out of alert (1.09 vs. 0.13 events per patient-year; P < 0.001). At the nominal alert threshold, 80.8% of HFEs were detected by a HeartLogic alert [95% confidence interval (CI): 69.9%-89.1%]. The median time from first true positive alert to an adjudicated clinical HFE was 53 days. The FPR was 1.16 (95% CI: 0.98-1.38) alerts per patient-year.
CONCLUSIONS
Results suggest that signs of worsening HF can be detected successfully with remote patient follow-up. The use of HeartLogic may predict periods of increased risk for HF or clinically significant events, allowing for early intervention and reduction of hospitalization in a vulnerable patient population.
PubMed: 38956896
DOI: 10.1002/ehf2.14890 -
The Journal of Contemporary Dental... Apr 2024The aim of the current study was to assess the cleaning and smear layer removal efficacy of two different rotary files with or without chemical agents on primary teeth.
AIM
The aim of the current study was to assess the cleaning and smear layer removal efficacy of two different rotary files with or without chemical agents on primary teeth.
MATERIALS AND METHODS
For the study, 90 extracted primary maxillary incisors without internal or external resorption and with at least two-thirds of complete roots were chosen. Then, based on the kind of instruments used to clean and shape the canals, they were randomly assigned to three experimental groups, each consisting of 30 teeth. Group-I: The canal was instrumented manually with K-files, Group-II: The canal was instrumented with Kedo-S files, Group-III: The canal was instrumented with Kedo-SG Blue files. After the canals were finally instrumented, 2 mL of QMix solution was used to irrigate 15 samples from each group. The samples were subsequently allowed to remain in the canals for 90 seconds in order to eliminate the smear layer. After that a stereomicroscope was used to assess the cleaning effectiveness.
RESULTS
With irrigant solution, the highest mean value was found in manual K-files (2.86 ± 0.34), followed by Kedo-S files group (1.34 ± 0.26) and Kedo-SG Blue files (1.28 ± 0.18). Without irrigant solution, the highest mean value was found in manual K-files (2.92 ± 0.22) followed by Kedo-S files group (1.44 ± 0.18) and Kedo-SG Blue files (1.36 ± 0.14). There was a statistically significant difference found at all the three levels.
CONCLUSION
On conclusion, the current study's findings demonstrated that irrigation solution was significantly more effective in cleaning and removing smear layers from pediatric rotary files than manual K-files.
CLINICAL SIGNIFICANCE
The effectiveness of endodontic therapy depends on a successful chemomechanical preparation. The canals are instrumented using either hand files or rotary instruments; there are several irrigation and instrumentation techniques. In order to completely sterilize the canals, chemical agents are utilized for irrigation during instrumentation. Due to their numerous biological, antibacterial, anti-inflammatory, and antioxidant qualities, many natural compounds are also utilized as irrigants. How to cite this article: Abushanan A. Evaluation of the Smear Layer Removal Ability of Various Rotary Files with/without Chemical Agents on Primary Teeth: An In Vitro Study. J Contemp Dent Pract 2024;25(4):354-357.
Topics: Tooth, Deciduous; Smear Layer; Humans; Root Canal Preparation; Root Canal Irrigants; In Vitro Techniques; Dental Instruments; Biguanides; Incisor; Equipment Design; Dental Pulp Cavity; Polymers
PubMed: 38956851
DOI: 10.5005/jp-journals-10024-3657 -
The Journal of Contemporary Dental... Apr 2024The aim of the study was to compare and evaluate the microleakage of fiber-reinforced glass ionomer cement (GIC) and conventional glass ionomer cement restorations... (Comparative Study)
Comparative Study
Comparative Evaluation of Microleakage of Fiber-reinforced Glass Ionomer Cement and Conventional Glass Ionomer Cement Restorations Immersed in Three Different Beverages: Study.
AIM
The aim of the study was to compare and evaluate the microleakage of fiber-reinforced glass ionomer cement (GIC) and conventional glass ionomer cement restorations immersed in three different beverages.
MATERIALS AND METHODS
A total of 96 human exfoliating deciduous molars were selected which were cleaned and disinfected. Standardized Class V cavity preparations were done and buccal surface were restored with experimental fiber-reinforced glass ionomer cement (Exp-FRGIC), lingual surface were restored with Type II conventional GIC. They were divided into four groups according to the test beverage. The samples were subjected to various immersion regimes and evaluated for microleakage under stereomicroscope.
RESULTS
Intragroup comparison for (Exp-FRGIC) showed significant microleakage when immersed in fresh fruit juice at high immersion whereas intragroup comparison in conventional GIC, showed highest microleakage with soft drink. Intergroup comparison of (Exp-FRGIC) in high immersion regime, showed more microleakage with specimen immersed in soft drink followed by fresh fruit juice.
CONCLUSION
It can thus be concluded that the three beverages used in the study affected the microleakage of both restorative materials significantly.
CLINICAL SIGNIFICANCE
Increasing usage of fruit juices in the pediatric diet has a definite impact on the progression of caries and it directly or indirectly affects the quality of restorations placed in the oral cavity. How to cite this article: George MA, Chandak SA, Khekade SH, . Comparative Evaluation of Microleakage of Fiber-reinforced Glass Ionomer Cement and Conventional Glass Ionomer Cement Restorations Immersed in Three Different Beverages: In Vitro Study. J Contemp Dent Pract 2024;25(4):346-353.
Topics: Glass Ionomer Cements; Humans; Dental Leakage; Dental Restoration, Permanent; In Vitro Techniques; Beverages; Materials Testing; Fruit and Vegetable Juices; Molar; Tooth, Deciduous
PubMed: 38956850
DOI: 10.5005/jp-journals-10024-3669 -
The Journal of Contemporary Dental... Apr 2024The aim of the current study was to evaluate the penetration depth and smear layer removal of root canal irrigant using various irrigation activation techniques. (Comparative Study)
Comparative Study
AIM
The aim of the current study was to evaluate the penetration depth and smear layer removal of root canal irrigant using various irrigation activation techniques.
MATERIALS AND METHODS
In this investigation, sixty single-rooted premolars extracted for orthodontic purposes were chosen. Diamond burs were used to create an access cavity, and #10 K-file was used to determine the patency. About sixty samples were divided into the following three groups (20 samples in each group), group I: Irrigation with conventional needle, group II: Activation of EndoVac system, group III: Passive ultrasonic irrigation (PUI). The efficacy of the smear layer was assessed using a scanning electron microscopy at a ×2000 magnification. One-way ANOVA was used to record and analyze the data. All statistical analyses were performed with a significance level of < 0.05.
RESULTS
At coronal third, the maximum smear layer was removed in group II (1.26 ± 0.02) followed by group III (1.84 ± 0.16) and group I (2.89 ± 0.21). At middle third, smear layer removal was maximum in group I (1.18 ± 0.10) followed by group III (1.72 ± 0.09) and group I (2.66 ± 0.18). At apical third, the more smear layer was removed in group II (1.02 ± 0.01) followed by group III (1.58 ± 0.08) and group I (2.38 ± 0.06). There was a highly significant difference found between the three different irrigation systems at all three levels ( < 0.001).
CONCLUSION
In conclusion, every irrigation device that was evaluated was successful in removing the smear layer from the root canal. However, the EndoVac system group removed a greater amount of smear layer compared with PUI and conventional needle group.
CLINICAL SIGNIFICANCE
With the goal of promoting cleaning that is beyond the ability of mechanical devices, irrigation is a crucial part of root canal therapy. If an efficient irrigation delivery system is used, the irrigants can reach the working length (WL). This type of distribution system needs to provide a suitable amount of irrigants up to the WL, as well as have enough flow and be effective at debriding the entire canal system. How to cite this article: Pujari MD, Das M, Das A, . Assessment of Smear Layer Removal and Penetration Depth of Root Canal Irrigant Using Different Irrigation Activation Systems: A Comparative Study. J Contemp Dent Pract 2024;25(4):331-334.
Topics: Root Canal Irrigants; Smear Layer; Humans; Therapeutic Irrigation; Root Canal Preparation; Microscopy, Electron, Scanning; Bicuspid; Dental Pulp Cavity; In Vitro Techniques
PubMed: 38956847
DOI: 10.5005/jp-journals-10024-3626 -
Asian Journal of Endoscopic Surgery Jul 2024We present a case of a recurrent inguinal bladder hernia that was previously unsuccessfully operated on three times and was repaired using totally extraperitoneal repair...
We present a case of a recurrent inguinal bladder hernia that was previously unsuccessfully operated on three times and was repaired using totally extraperitoneal repair (TEP). A 79-year-old man presented with a right inguinal swelling that had been treated three times on the same side with anterior approaches. Computed tomography confirmed a recurrent inguinal bladder hernia. TEP was performed after identifying the bladder hernia preoperatively, with previous surgeries that used a plug-and-patch technique through an anterior approach. The extraperitoneal approach allowed the bladder to be reduced without injury and the hernia to be safely repaired using a 3D Max® Light Mesh. The postoperative recovery was uneventful, with no recurrence after 1 year. TEP facilitates the diagnosis and repair of bladder hernias, emphasizing the importance of preoperative diagnosis and the efficacy of endoscopic procedures in bladder hernia repair, even in recurrent cases.
Topics: Humans; Male; Hernia, Inguinal; Aged; Herniorrhaphy; Recurrence; Laparoscopy; Surgical Mesh; Urinary Bladder Diseases
PubMed: 38956777
DOI: 10.1111/ases.13352 -
International Neurourology Journal Jun 2024This study was performed to assess the risk factors for artificial urinary sphincter (AUS) explantation in a large multicenter cohort.
PURPOSE
This study was performed to assess the risk factors for artificial urinary sphincter (AUS) explantation in a large multicenter cohort.
METHODS
We retrospectively reviewed the medical records for all 1,233 implantations of the AMS-800 AUS device in male nonneurological patients from 2005 to 2020 across 13 French centers. Patients with neurological conditions were excluded from the study. To identify factors associated with explantation-free survival, survival analysis was performed. Explantation was defined as the complete removal of the device, whereas revision referred to the replacement of the device or its components.
RESULTS
The study included 1,107 patients, of whom 281 underwent AUS explantation. The median survival without explantation was 83 months. The leading causes of explantation were infection and erosion. Univariate analysis revealed several significant risk factors for explantation: age above 75 years (34.6% in the explanted group vs. 25.8% in the nonexplanted group, P=0.007), history of radiotherapy (43.5% vs. 31.3%, P=0.001), and anticoagulant use (15% vs. 8.6%, P<0.001). In logistic regression analysis, the only significant risk factor was previous radiotherapy (odds ratio [OR], 2.05; P<0.05). Cox proportional hazards analysis revealed 2 factors associated with earlier explantation: transcorporal cuff implantation (hazard ratio [HR], 2.67; P=0.01) and the annual caseload of the center (HR, 1.08; P=0.02). When specifically examining explantation due to erosion, radiotherapy was the sole factor significantly associated with the risk of erosion (OR, 2.47; P<0.05) as well as earlier erosion (HR, 1.90; P=0.039).
CONCLUSION
In this series, conducted in a real-world setting across multiple centers with different volumes and levels of expertise, the median survival without AUS explantation was 83 months. This study confirms that radiotherapy represents the primary independent risk factor for AUS erosion in male nonneurological patients.
PubMed: 38956774
DOI: 10.5213/inj.2448086.043 -
Stem Cell Research & Therapy Jul 2024Repairation of bone defects remains a major clinical problem. Constructing bone tissue engineering containing growth factors, stem cells, and material scaffolds to...
BACKGROUND
Repairation of bone defects remains a major clinical problem. Constructing bone tissue engineering containing growth factors, stem cells, and material scaffolds to repair bone defects has recently become a hot research topic. Nerve growth factor (NGF) can promote osteogenesis of bone marrow mesenchymal stem cells (BMSCs), but the low survival rate of the BMSCs during transplantation remains an unresolved issue. In this study, we investigated the therapeutic effect of BMSCs overexpression of NGF on bone defect by inhibiting pyroptosis.
METHODS
The relationship between the low survival rate and pyroptosis of BMSCs overexpressing NGF in localized inflammation of fractures was explored by detecting pyroptosis protein levels. Then, the NGF/BMSCs-NSA-Sca bone tissue engineering was constructed by seeding BMSCs overexpressing NGF on the allograft bone scaffold and adding the pyroptosis inhibitor necrosulfonamide(NSA). The femoral condylar defect model in the Sprague-Dawley (SD) rat was studied by micro-CT, histological, WB and PCR analyses in vitro and in vivo to evaluate the regenerative effect of bone repair.
RESULTS
The pyroptosis that occurs in BMSCs overexpressing NGF is associated with the nerve growth factor receptor (P75NTR) during osteogenic differentiation. Furthermore, NSA can block pyroptosis in BMSCs overexpression NGF. Notably, the analyses using the critical-size femoral condylar defect model indicated that the NGF/BMSCs-NSA-Sca group inhibited pyroptosis significantly and had higher osteogenesis in defects.
CONCLUSION
NGF/BMSCs-NSA had strong osteogenic properties in repairing bone defects. Moreover, NGF/BMSCs-NSA-Sca mixture developed in this study opens new horizons for developing novel tissue engineering constructs.
Topics: Animals; Nerve Growth Factor; Mesenchymal Stem Cells; Rats; Tissue Scaffolds; Rats, Sprague-Dawley; Osteogenesis; Bone Regeneration; Allografts; Male; Tissue Engineering; Pyroptosis; Sulfonamides; Cell Differentiation; Mesenchymal Stem Cell Transplantation; Bone Transplantation
PubMed: 38956719
DOI: 10.1186/s13287-024-03807-z -
Italian Journal of Pediatrics Jul 2024Cortical visual impairment (CVI) is a verifiable visual dysfunction that cannot be attributed to disorders of the anterior visual pathways or any potentially...
BACKGROUND
Cortical visual impairment (CVI) is a verifiable visual dysfunction that cannot be attributed to disorders of the anterior visual pathways or any potentially co-occurring ocular impairment. Given the limited knowledge on the most effective interventions for visual impairment resulting from CVI, this case report provides valuable insights into an example of successful implementation of anti-amblyopia therapy in a patient with CVI.
CASE PRESENTATION
This case report presents a 5-year-old girl with CVI secondary to hypoxic-ischemic injury, resulting in visual impairment, dyspraxia, and abnormal visual evoked potential testing. The girl did not suffer from amblyopia, there was no evidence of relevant refractive errors or strabismus, so visual pathway damage was the cause of her visual deficit. Nevertheless, the patient underwent anti-amblyopia therapy and showed significant improvement in visual acuity after 12 months of treatment. The improvement, resulting from visual stimulation, was due to a good functional recovery by a better usage of the damaged visual pathways. The therapy included prescribing corrective glasses and implementing secondary occlusion of the better eye for 4 months, which was protracted for another 4 months, leading to further improvements in visual acuity.
CONCLUSIONS
The case report shows that addressing even minor refractive errors and implementing anti-amblyopia therapy can significantly improve vision in children with CVI, even without co-existing amblyopia. It also highlights the importance of early intervention and multidisciplinary rehabilitation in children with CVI, focusing on motor and cognitive skills. Additionally, it emphasizes the need for further research to establish evidence-based practice standards for improving vision in children with CVI.
Topics: Humans; Female; Child, Preschool; Amblyopia; Visual Acuity; Eyeglasses; Blindness, Cortical; Hypoxia-Ischemia, Brain; Evoked Potentials, Visual
PubMed: 38956699
DOI: 10.1186/s13052-024-01679-w -
Journal of Translational Medicine Jul 2024Mesenchymal stem and stromal cells (MSCs) hold potential to treat a broad range of clinical indications, but clinical translation has been limited to date due in part to...
Manufacturing mesenchymal stromal cells in a microcarrier-microbioreactor platform can enhance cell yield and quality attributes: case study for acute respiratory distress syndrome.
Mesenchymal stem and stromal cells (MSCs) hold potential to treat a broad range of clinical indications, but clinical translation has been limited to date due in part to challenges with batch-to-batch reproducibility of potential critical quality attributes (pCQAs) that can predict potency/efficacy. Here, we designed and implemented a microcarrier-microbioreactor approach to cell therapy manufacturing, specific to anchorage-dependent cells such as MSCs. We sought to assess whether increased control of the biochemical and biophysical environment had the potential to create product with consistent presentation and elevated expression of pCQAs relative to established manufacturing approaches in tissue culture polystyrene (TCPS) flasks. First, we evaluated total cell yield harvested from dissolvable, gelatin microcarriers within a microbioreactor cassette (Mobius Breez) or a flask control with matched initial cell seeding density and culture duration. Next, we identified 24 genes implicated in a therapeutic role for a specific motivating indication, acute respiratory distress syndrome (ARDS); expression of these genes served as our pCQAs for initial in vitro evaluation of product potency. We evaluated mRNA expression for three distinct donors to assess inter-donor repeatability, as well as for one donor in three distinct batches to assess within-donor, inter-batch variability. Finally, we assessed gene expression at the protein level for a subset of the panel to confirm successful translation. Our results indicated that MSCs expanded with this microcarrier-microbioreactor approach exhibited reasonable donor-to-donor repeatability and reliable batch-to-batch reproducibility of pCQAs. Interestingly, the baseline conditions of this microcarrier-microbioreactor approach also significantly improved expression of several key pCQAs at the gene and protein expression levels and reduced total media consumption relative to TCPS culture. This proof-of-concept study illustrates key benefits of this approach to therapeutic cell process development for MSCs and other anchorage-dependent cells that are candidates for cell therapies.
Topics: Mesenchymal Stem Cells; Humans; Respiratory Distress Syndrome; Bioreactors; Gene Expression Regulation; Cell Culture Techniques; RNA, Messenger; Reproducibility of Results
PubMed: 38956643
DOI: 10.1186/s12967-024-05373-7 -
BMC Oral Health Jul 2024The intrusion of maxillary anterior teeth is often required and there are various intrusion modes with mini-implants in clear aligner treatment. The objective of this...
BACKGROUND
The intrusion of maxillary anterior teeth is often required and there are various intrusion modes with mini-implants in clear aligner treatment. The objective of this study was to evaluate the effectiveness of maxillary anterior teeth intrusion with different intrusion modes, aiming to provide references for precise and safe intrusion movements in clinical practice.
METHODS
Cone-beam computed tomography and intraoral optical scanning data of a patient were collected. Finite element models of the maxilla, maxillary dentition, periodontal ligaments (PDLs), clear aligner (CA), attachments, and mini-implants were established. Different intrusion modes of the maxillary anterior teeth were simulated by changing the mini-implant site (between central incisors, between central and lateral incisor, between lateral incisor and canine), loading site (between central incisors, on central incisor, between central and lateral incisor, between lateral incisor and canine), and loading mode (labial loading and labiolingual loading). Ten conditions were generated and intrusive forces of 100 g were applied totally. Then displacement tendency of the maxillary anterior teeth and CA, and stress of the PDLs were analyzed.
RESULTS
For the central incisor under condition L14 and for the canine under conditions L11, L13, L23, and L33, the intrusion amount was negative. Under other conditions, the intrusion amount was positive. The labiolingual angulation of maxillary anterior teeth exhibited positive changes under all conditions, with greater changes under linguoincisal loading. The mesiodistal angulation of canine exhibited positive changes under labial loading, while negative changes under linguoincisal loading except for condition L14.
CONCLUSIONS
The intrusion amount, labiolingual and mesiodistal angulations of the maxillary anterior teeth were affected by the mini-implant site, loading site, and loading mode. Labial and linguoincisal loading may have opposite effects on the intrusion amount of maxillary anterior teeth and the mesiodistal angulation of canine. The labiolingual angulation of the maxillary incisors would increase under all intrusion modes, with greater increases under linguoincisal loading.
Topics: Humans; Finite Element Analysis; Tooth Movement Techniques; Maxilla; Incisor; Dental Implants; Cone-Beam Computed Tomography; Orthodontic Anchorage Procedures; Periodontal Ligament; Imaging, Three-Dimensional; Cuspid; Orthodontic Appliance Design; Dental Stress Analysis; Biomechanical Phenomena; Orthodontic Appliances, Removable
PubMed: 38956625
DOI: 10.1186/s12903-024-04537-7