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Aims: To compare tooth-(TSRP) and implant-supported (ISRP) removable prostheses in terms of abutment and prosthesis survival (PICO 1) and estimated cumulative survival of teeth/implants and prostheses (PICO 2) at ≥12-month post-prosthesis delivery in patients with stage IV periodontitis. Materials and Methods: Five databases were searched to identify RCTs, CCTs, single arms, prospective cohort studies, case series and retrospective studies. Duplicate screening was performed, and ranges for abutment and prosthesis survival were calculated. Results: Twenty-six studies were included in the qualitative assessment. Only one study with critical risk of bias comparing the two treatment modalities reported similar survival rates at 2 years. Overall, prospective studies on ISRPs indicated an implant survival rate ranging from 96.4% to 100% and a prosthesis survival rate of 100% with a follow-up from 12 to 54 months. Prospective studies on TSRPs indicated a tooth survival ranging from 85.71% to 100% at 1-to 10-years follow-up. Conclusions: The available evidence is of poor quality, and it does not allow to make robust conclusions on the efficacy of these rehabilitations in stage IV periodontitis patients. Particularly for TSRPs, careful patient selection is crucial and a certain number of biological and prosthetic complications should be expected. [ABSTRACT FROM AUTHOR]

Background: Three millimeter is considered as the minimum distance to obtain soft and bone tissue stability in case of adjacent implants. The possibility to preserve peri‐implant bone level using a platform switching connection has questioned this concept. Purpose The study evaluates soft tissue maintenance and marginal bone stability around implants, placed at 2 or 3 mm of distance. Materials and methods: Thirty patients received two immediately loaded implants either at 2‐mm (test) or at 3‐mm (control) of distance in the premolar area. Soft tissue esthetics (papilla height and fill, keratinized tissue, recession) and radiographic peri‐implant bone level changes were measured at 3, 6, and 12 months. Results: No significant differences between the two groups were detected neither for all soft tissue esthetic outcomes nor for bone level modifications up to 12 months. Conclusion: The results suggested that up to 12 months post‐loading, both 2‐ and 3‐mm inter‐distance platform‐switched implants in healed site, supported adequate esthetic outcomes and peri‐implant bone stability. [ABSTRACT FROM AUTHOR]

Photogrammetry is a three‐dimensional acquisition method potentially applicable to the forensic field. This possibility requires the verification of its accuracy. In this study, 3D volumes of skulls are generated to compare the photogrammetry versus the CT scan. In order to provide eligible material to the photogrammetric software, photographs were captured at a distance of 30 cm from the skull placed on a support 1 m in height and illuminated with diffused laboratory ceiling artificial light. A Nikon Coolpix P7100 camera was used. Photographs capture common elements with the previous and the next photograph so as to allow the photogrammetric software to recognize these common points between photographs and create a 3D puzzle. The Zephyr Lite (3DFlow©) software was employed to register the 3D volume. CT‐based skulls are taken as a metric reference. The photogrammetry‐based skulls are then enlarged according to the measurements of some landmarks or Zygion and Zygion, the distance between end of nasal and base of nasal pyramid for frontal projection, and minimum breadth of the mandibular ramus for the right lateral projection. The accuracy of the photogrammetry is compared to that of the CT scan by measuring the 3D volumes of the skulls studied. Specific landmarks are used as reference points for the measures in both frontal and lateral views. Bland–Altman graph shows homogeneity. The mean difference (1.28 mm) indicates that the measurements taken on the photogrammetry‐based skull tend to slightly overestimate compared with the measurements taken on the CT‐based skull. [ABSTRACT FROM AUTHOR]

Background: Considering the role of the inflammatory host response in the pathogenesis of periodontitis, different host modulators have been proposed to enhance the outcomes of non‐surgical periodontal therapy (NSPT), but their efficacy has not been fully clarified. Objectives: This systematic review investigated the efficacy of host modulators combined with NSPT in reducing probing pocket depth (PPD) in periodontitis patients. Materials and methods: Placebo‐controlled RCTs with ≥6 months follow‐up were searched. Meta‐analysis was conducted when ≥5 studies using the same host modulator were identified. Results: Fifty eight studies met the inclusion criteria. After 6 months, local administration of 1.2% statin gels as adjuncts to NSPT significantly improved PPD reduction (1.83 mm) in infrabony defects and systemic administration of sub‐antimicrobial dose doxycycline (SDD) in addition to NSPT improved PPD reduction of deep pockets. Administration of probiotics conferred limited clinical benefits. Local bisphosphonate and metformin gels showed potential for clinical use in infrabony defects, which needs to be confirmed. Conclusions: Local delivery of statins in infrabony defects and systemic SDD for deep pockets may confer additional clinical benefits to NSPT. Their long‐term effectiveness and safety need to be confirmed in independent multi‐centred studies. Further studies are needed to confirm the benefit of other host modulators. [ABSTRACT FROM AUTHOR]

Some forms of early ECG repolarization QRS pattern (ERp) with J‐point elevation of 0.1 mV in two contiguous inferior and/or lateral leads with or without ST‐elevation are potentially associated with a higher arrhythmic risk in adults. We assessed the prevalence of ERp among non‐professional adolescent athletes and correlated it with age, sex, ethnicity, and structural and electric cardiac parameters. We retrospectively analyzed 414 ECGs obtained from young athletes referred to our center from 2006 to 2017. We found ERp in 22% of cases. In the ERp group, we found a greater percentage of black athletes, a higher systolic blood pressure, and lower heart rate (HR) compared with the group without ERp. This pattern was less frequent in female athletes. In athletes with ERp, the occurrence of ventricular ectopic beats was less frequent and QRS‐duration was shorter. They also exhibited greater (a) ECG‐based left ventricular hypertrophy (LVH), (b) left ventricular mass, and (c) relative wall thickness (RWT), suggesting a tendency to concentric geometry. At logistic regression analysis, we found that HR (OR 0.98 [0.96‐0.99] P = .013), QRS‐duration (OR 0.96 [0.94‐0.99], P = .003), LVH (OR 1.09 [1.05‐1.12], P < .001), and RWT (OR 1.08 [1.01‐1.16] P = .032) were significant predictors of ERp incidence. ERp is quite common in adolescent athletes and correlates with concentric LV remodeling. Specific clinical and ECG‐findings related to training such as lower HR, LVH, and QRS‐duration are also predictors of ERp. In adolescent non‐professional athletes, ERp is a benign finding associated with some structural and electric cardiac modifications induced by training. [ABSTRACT FROM AUTHOR]

Objectives: The role of dental plaque in gingival lesions caused by oral lichen planus has not been fully defined. The aim of this clinical trial was to evaluate the effects of oral healthcare motivation on clinical variables in patients with gingival oral lichen planus. Material and Methods: Oral lichen planus patients with symptomatic gingival lesions were randomized in control and intervention groups. The intervention group was instructed to effectively remove bacterial biofilm from dental surfaces, while controls did not receive any advice. The outcome variables were as follows: quality of life (OHIP‐14), pain, plaque index and clinical severity of the disease (Escudier index). Outcome variables were assessed at 0, 4 and 20 weeks and analysed using an ANOVA model for factorial design. Results: Data from 60 patients were collected. Regression analysis showed a significant positive trend of OHIP‐14, plaque index and Escudier index in the intervention group compared to controls (p < 0.05). Pain did not prove significantly different (p = 0.408). Conclusions: Plaque control improved both OHIP‐14 and gingival lesion clinical severity. Oral hygienists should be involved in the multidisciplinary management of patients affected by oral lichen planus with gingival lesions. [ABSTRACT FROM AUTHOR]

The article presents a study which examined the possible role played by bone marrow (BM) levels of such cytokines and chemokines as Activin A, C-C motif chemokine ligand 20 (CCL20), and Dickkopf 1 (DKK-1) in the progression of smouldering multiple myeloma (MM) in patients. Topics include the role of DKK-1 in tumoural progression via the increase in the number of myeloid-derived suppressor cells (MDSC) and the use of enzyme-linked immunosorbent assay (ELISA) kits in BM plasma analysis.

Objective: Since Behçet's syndrome (BS) is the prototype of inflammation‐induced thrombosis, immunosuppressants are recommended in place of anticoagulants. We undertook this study to assess the clinical efficacy and the corticosteroid‐sparing effect of adalimumab (ADA)–based treatment versus disease‐modifying antirheumatic drug (DMARD) therapy in a large retrospective cohort of patients with BS‐related venous thrombosis. Methods: We retrospectively collected data on 70 BS patients treated with DMARDs or ADA‐based regimens (ADA with or without DMARDs) because of venous complications. Clinical and imaging evaluations were performed to define vascular response. We explored differences in outcomes between ADA‐based regimens and DMARDs with respect to efficacy, corticosteroid‐sparing role, and time on treatment. We also evaluated the role of anticoagulants as concomitant treatment. Results: After a mean ± SD follow‐up period of 25.7 ± 23.2 months, ADA‐based regimens induced clinical and imaging improvement of venous thrombosis more frequently (P = 0.001) and rapidly (P < 0.0001) than did DMARDs. The mean dose of corticosteroids administered at the last follow‐up visit was significantly lower with ADA‐based regimens than with DMARDs (P < 0.0001). The time on treatment was significantly longer with ADA plus DMARDs than with DMARDs alone (P = 0.002). No differences were found in terms of efficacy and time on treatment between DMARDs or ADA‐based regimens among patients who received anticoagulants and those who did not. Conclusion: In this large retrospective study, we have shown that ADA‐based regimens are more effective and rapid than DMARDs in inducing resolution of venous thrombosis in BS patients, allowing reduction of steroid exposure. Moreover, our findings suggest that anticoagulation does not modify the efficacy of either ADA‐based regimens or DMARDs for venous complications. [ABSTRACT FROM AUTHOR]

Objective Adult-onset IgA vasculitis (Henoch-Schönlein) (Ig AV) is a rare systemic vasculitis characterized by IgA1-dominant deposits. The treatment of adult-onset Ig AV is controversial and is based on the combination of glucocorticoids and immunosuppressive agents, but many patients have refractory or relapsing disease despite treatment. Rituximab ( RTX) is a B cell-depleting antibody of proven efficacy in antineutrophil cytoplasmic antibody-associated vasculitis. We undertook this study to test the efficacy and safety of RTX in a multicenter cohort of patients with adult-onset Ig AV. Methods In this multicenter observational study, we included patients with adult-onset Ig AV who had received RTX either for refractory/relapsing disease or because they had contraindications to conventional glucocorticoid/immunosuppressive therapy. We analyzed the rates of remission (defined on the basis of the Birmingham Vasculitis Activity Score [ BVAS]) and relapse as well as the variations over time in estimated glomerular filtration rate ( GFR), proteinuria, C-reactive protein ( CRP) level, BVAS, and prednisone dose. Results Twenty-two patients were included; their median duration of follow-up was 24 months (interquartile range 18-48 months). Sixteen patients received RTX as add-on therapy and 6 as monotherapy. Twenty patients (90.9%) achieved remission, and 7 of those 20 patients (35%) had subsequent relapse of disease. There were significant reductions in 24-hour proteinuria ( P < 0.0001), CRP level ( P = 0.0005), BVAS ( P < 0.0001), and prednisone dose ( P < 0.0001) from RTX initiation through the last follow-up visit; estimated GFR remained stable. RTX was generally well tolerated. One patient died after 60 months of follow-up. Conclusion Our data suggest that RTX is an effective and safe therapeutic option for adult-onset Ig AV. [ABSTRACT FROM AUTHOR]

Structural Remodeling in Atrial Fibrillation. Introduction: Atrial fibrillation (AF) in mitral regurgitation (MR) is a complex disease where multiple factors may induce left-atrial structural remodeling (SR). We explored the differential SR of the left-atrial posterior wall (LAPW) of patients affected by MR with or without persistent AF, and the expression of key proteins involved in its pathogenesis. Methods and Results: Light microscopy of LAPW samples from 27 patients with MR and persistent AF (group 1), 33 with MR in sinus rhythm (group 2), and 15 autopsy controls (group 3) was used to measure myocyte diameter, percentage of myocytolytic myocytes, interstitial fibrosis, and capillary density; RT-PCR and Western blotting were used to assess the mRNA and protein levels of SOD-1, SOD-2, HO-1, calpain, MMP-2, MMP-9, TIMP-1, TIMP-2, and VEGF; immunofluorescence was used to locate these proteins. Myocyte diameter was similar in groups 1 and 2, but larger than controls. Compared to group 2, group 1 had more myocytolytic myocytes (20.8 ± 5.6% vs 14.7 ± 4.5%; P < 0.0001), increased interstitial fibrosis (10.4 ± 5.1% vs 7.5 ± 4.2%; P < 0.05), and decreased capillary density (923 ± 107 No/mm2 vs 1,040 ± 100 No/mm2; P < 0.0001). All of the proteins were more expressed in groups 1 and 2 than in controls. The protein and mRNA levels of SOD-1, SOD-2, MMP-2, and MMP-9 were higher in group 1 than in group 2. Conclusions: The LAPW of MR patients with or without AF shows considerable SR. The former has more severe histopathological changes and higher levels of proteins involved in SR, thereby reaching a threshold beyond which the sinus impulse cannot normally activate atrial myocardium. (J Cardiovasc Electrophysiol, Vol. 23 p. 271-279, March 2012.) [ABSTRACT FROM AUTHOR]

Background. Inhalation of thermal water has been used empirically in the treatment of chronic diseases of upper and lower respiratory tract. This study investigates biomarkers of effect in exhaled breath (nitric oxide (NO)) and in exhaled breath condensate (EBC) (hydrogen peroxide (H2O2), anions, toxic heavy metals of tobacco smoke) for patients with lung diseases inhaling salt-bromide-iodine thermal water. Methods. This study enrolled two groups of patients, twenty with alveolar pulmonary diseases--pneumoconiosis--twenty-two with bronchial diseases. Patients received 12 days inhalation treatment with thermal water in Terme of Monticelli (Parma), Italy. Results. No statistically significant differences were found for NO at different flow rates in both groups of patients before and after thermal water inhalation. Also in EBC no statistically significant differences were present for H2O2 concentrations, toxic heavymetals concentrations, and anion concentrations before and after treatment. Nitrates in EBC were found to be significantly higher in patients before inhalation than in controls as well as in patients after inhalation versus controls. Conclusions. This study contributes to better quantify functional and biochemical changes in airways before and after thermal water treatment. [ABSTRACT FROM AUTHOR]

For the purpose of detecting early left ventricle (LV) abnormalities in normotensive offspring of hypertensive parents (EH+), 23 normotensive sedentary male EH+ (age 25 ± 3 years) and 20 matched offspring of normotensive families (EH-), underwent: clinic bloop pressure (BP) measurement, 24-hour ambulatory BP monitoring (ABPM), frequency-domain parameters of autonomic heart rate control and conventional and Doppler tissue echocardiographic (DTE) study of both ventricles, including relative wall thickness (RWT) as an index of LV remodeling. EH+ subjects had slightly higher office systolic and diastolic (P < 0.05), average 24-hour systolic (P < 0.001), diastolic (P < 0.01), and mean BP (P < 0.05). No between-group differences were detected for heart rate variability, LV mass and systolic and diastolic function in both ventricles. RWT was greater in EH+ (0.38 ± 0.05 vs. 0.34 ± 0.03 SD; P < 0.01), which was significantly related, at the univariate analysis, to the condition of EH+ (P < 0.004) and to the clinic and ambulatory BP parameters as well (P = 0.06-0.01). However, at the stepwise multiple regression analysis, with RWT used as the dependent variable, only the condition of EH+ was independently associated with RWT (P < 0.008), whereas BP did not. RWT, according to receiver operating characteristic curves analysis, predicted the condition of EH+ (cutoff point 0.369, specificity 90%, sensitivity 65%). Our data suggest that an higher RWT, as an index towards LV concentric remodeling, is the earliest change in LV geometry in EH+ subjects, independent of any slight elevation in BP. Thus, RWT measurement may be a quite specific tool to detect early LV alterations due to the condition of EH+. (Echocardiography 2011;28:821-828) [ABSTRACT FROM AUTHOR]

In a public hospital, eight cases of fatal poisoning by nitrous oxide (N2O) occurred under oxygen administration, due to an erroneous swapping of the lines in the gas system. The aim of the study was to clarify the factors involved in asphyxia by characterizing gases from different lines and measuring N2O concentrations in postmortem biological samples from bodies exhumed. Analyses carried out on the gas system confirmed the erroneous substitution of O2 line with N2O and air line with O2. Consequently, high N2O amounts were revealed in several tissues and gaseous biological samples. All specimens were analyzed by headspace gas chromatography technique. A rigorous quantitative analysis was possible only in blood (11.29–2152.04 mg/L) and urine (95.11 mg/L) and in air samples from stomach and trachea (from 5.28 to 83.63 g/m3). This study demonstrates that N2O can be detected in biological samples even 1 month after death. [ABSTRACT FROM AUTHOR]

This study was aimed at: (i) investigating the expression profiles of some antioxidant and epidermal growth factor receptor genes in cancerous and unaffected tissues of patients undergoing lung resection for non-small cell lung cancer (NSCLC) (cross-sectional phase), (ii) evaluating if gene expression levels at the time of surgery may be associated to patients' survival (prospective phase). Antioxidant genes included heme oxygenase 1 (HO-1), superoxide dismutase-1 (SOD-1), and -2 (SOD-2), whereas epidermal growth factor receptor genes consisted of epidermal growth factor receptor (EGFR) and v-erb-b2 erythroblastic leukaemia viral oncogene homolog 2 (HER-2). Twenty-eight couples of lung biopsies were obtained and gene transcripts were quantified by Real Time RT-PCR. The average follow-up of patients lasted about 60 months. In the cancerous tissues, antioxidant genes were significantly hypo-expressed than in unaffected tissues. The HER-2 transcript levels prevailed in adenocarcinomas, whereas EGFR in squamocellular carcinomas. Patients overexpressing HER-2 in the cancerous tissues showed significantly lower 5-year survival than the others. [ABSTRACT FROM AUTHOR]

In risk assessment, no observed exposure level (NOAEL) and benchmark dose (BMD) are usually derived either from epidemiological studies in humans or from animal experiments. In many in vitro studies, concentration-effect/response curves have been analyzed using different mathematical models finalized to the identification of EC[sub 50]. In the present article, we propose a model to fit dose-response curves in vitro. The BMD approach has been used to compare the cell viability (MTT assay) of different rat (C6 and PC12, glial and neuronal, respectively) and human cell lines (D384 and SK-N-MC, glial and neuronal, respectively) after 24-hour exposure to the following neurotoxic substances: manganese chloride (MnCl[sub 2]), methyl-mercury (Me-Hg), and the enantiomers of styrene oxide (SO). For all rat and human cell lines, the potency of the examined compounds was: MnCl[sub 2] < S-SO < R-SO < Me-Hg . A preliminary comparison with in vivo toxicity data for these substances gave rise to consistent results. Whereas a reasonable agreement between in vitro and in vivo data has been found for Mn and styrene oxide, a wide scatter of LOAEL has been reported for Me-Hg and these appear to be either much higher or lower than the BMD for the MTT assay we observed invitro. [ABSTRACT FROM AUTHOR]