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There are currently limited means by which lesion formation can be confirmed during radiofrequency ablation procedures. The purpose of this study was to evaluate the use of NIRS-integrated RFA catheters for monitoring irrigated lesion progression, ex vivo and in vivo. Open-irrigated NIRS-ablation catheters with optical fibers were fabricated to sample tissue diffuse reflectance. Spectra from 44 irrigated lesions and 44 non-lesion sites from ex vivo swine hearts (n = 15) were used to train and evaluate a predictive model for lesion dimensions based on key spectral features. Additional studies were performed in diluted blood to assess NIRS signatures of catheter-tissue contact status. Finally, the potential of NIRS-RFA catheters for guiding lesion delivery was evaluated in a set of in vivo pilot studies conducted in healthy pigs (n = 4). Model predictions for lesion depth (R = 0.968), width (R = 0.971), and depth percentage (R = 0.924) correlated well with measured lesion dimensions. In vivo deployment in preliminary trials showed robust translational consistency of contact discrimination (P

This two-arm, parallel-group, tooth-randomised, controlled noninferiority clinical trial aimed to compare survival rates between the sealing and restoring of cavitated occlusal carious lesions in dentine [International Caries Detection and Assessment System (ICDAS) 5] of deciduous molars using resin-modified glass-ionomer cement (RMGIC) and to assess caries progression radiographically. A total of 68 molars with ICDAS 5 occlusal lesions were randomly allocated into two groups, a sealing group (n = 31), in which RMGIC was placed directly over the carious lesion, and a restoration group (n = 37), in which a restoration with the same material was placed after selective caries removal. During the baseline and follow-up visits, dental caries was registered and caries activity was assessed according to a visuotactile criterion. At baseline, patient caries status (dmf-t) and cavity depth and extent (mesiodistal and buccolingual) were measured before RMGIC placement. An independent and blinded examiner evaluated the treated teeth using the USPHS criteria after one and two years. Standardised interproximal radiographs were taken for caries progression assessments. During the follow-up period, no lesion progression was observed radiographically. After one year (n = 60; 27 sealed and 33 restored) and two years (n = 48; 23 sealed and 25 restored) of follow-up, the treatment success rates were 78.8% and 76.0% in the restoration group and 59.3% and 47.8% in the sealing group, respectively. Multivariate Cox regression showed that lesions smaller than 2 mm in the mesiodistal extent were less prone to fail after one year (p = 0.03). However, survival curves (log-rank test) were statistically significantly different only after two years (p

Objective To identify the best available approach to avoid initial caries lesions progression in primary teeth. Materials and methods Search was performed in MEDLINE/Pubmed, Web of Science, Embase and CENTRAL databases until March 2021. Studies compared treatment options to avoid the initial caries lesion progression with at least 12 months of follow-up were included. Network meta-analyses were conducted considering the non-progression of caries lesions as an outcome. Results Potentially eligible studies were screened (n = 2820) and eleven were included. Six studies evaluated the use of fluoride varnish, resin infiltration, sealing, and toothbrushing/flossing on proximal initial caries lesions. When considering occlusal surfaces, only two studies evaluating the ozone gas, fluoride varnish, resin infiltration, and sealants were included. For buccal/lingual surfaces, three studies evaluating toothbrushing, CPP-ACP paste, fluoride varnish, and resin infiltration were included. For all types of surfaces, the resin infiltration showed the best probability to avoid the progression of initial caries lesions. Conclusion The limited number of included studies, most with a high risk of bias and lack of hard outcomes, such as frank cavitation, makes it not feasible to recommend a specific management approach for initial caries lesion control in primary teeth with a high certainty of evidence. PROSPERO: #CRD42016037781.

Data suggest that patients with pediatric-onset multiple sclerosis (POMS) should initiate treatment with a disease-modifying therapy early to slow progression. The PARADIGMS trial demonstrated that oral fingolimod reduced the annual rate of relapse by 82% compared with intramuscular interferon beta-1a in children with POMS. The PARADIGMS study had a follow-up of 2 years, but no data are available about the safety and efficacy of fingolimod for longer periods in children with POMS. Here we present two cases of children with POMS who achieved sustained clinical benefit from treatment with fingolimod for more than 2 years. The first patient, an 11-year-old male, who participate in the PARADIGMS study, was treatment naïve at the time of fingolimod initiation. His clinical condition remained stable over 5 years of treatment, with no relapses and no radiological lesion progression. The second patient was a female who initiated fingolimod at the age of 12 years, 2 years after her POMS diagnosis and after an 8-month trial of interferon beta-1a. The patient had experienced two relapses during interferon beta-1a but had no relapses in more than 2 years of treatment with fingolimod, and her MRI scans showed no new or active lesions. These data show that prolonged treatment with fingolimod can be safe and effective during long-term treatment as first- or second-line therapy in children with POMS.

Background Infiltration and sealing are micro-invasive treatments for arresting proximal non-cavitated caries lesions; however, their efficacies under different conditions remain unknown. This systematic review and meta-analysis aimed to evaluate the caries-arresting effectiveness of infiltration and sealing and to further analyse their efficacies across different dentition types and caries risk levels. Methods Six electronic databases were searched for published literature, and references were manually searched. Split-mouth randomised controlled trials (RCTs) to compare the effectiveness between infiltration/sealing and non-invasive treatments in proximal lesions were included. The primary outcome was obtained from radiographical readings. Results In total, 1033 citations were identified, and 17 RCTs (22 articles) were included. Infiltration and sealing reduced the odds of lesion progression (infiltration vs. non-invasive: OR = 0.21, 95% CI 0.15–0.30; sealing vs. placebo: OR = 0.27, 95% CI 0.18–0.42). For both the primary and permanent dentitions, infiltration and sealing were more effective than non-invasive treatments (primary dentition: OR = 0.30, 95% CI 0.20–0.45; permanent dentition: OR = 0.20, 95% CI 0.14–0.28). The overall effects of infiltration and sealing were significantly different from the control effects based on different caries risk levels (OR = 0.20, 95% CI 0.14–0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI 0.01–8.27), there were significant differences between micro-invasive and non-invasive treatments (low risk: OR = 0.24, 95% CI 0.08–0.72; low to moderate risk: OR = 0.38, 95% CI 0.18–0.81; moderate to high risk: OR = 0.17, 95% CI 0.10–0.29; and high risk: OR = 0.14, 95% CI 0.07–0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI 0.01–8.27), infiltration was superior (low risk: OR = 0.24, 95% CI 0.08–0.72; low to moderate risk: OR = 0.38, 95% CI 0.18–0.81; moderate to high risk: OR = 0.20, 95% CI 0.10–0.39; and high risk: OR = 0.14, 95% CI 0.05–0.37). Conclusion Infiltration and sealing were more efficacious than non-invasive treatments for halting non-cavitated proximal lesions.

Rheumatoid arthritis (RA) is a common form of chronic inflammatory arthritis, and it mainly causes the destruction of small joints. The development of this disease is a relatively secret and repeated process, and therefore early diagnosis and evaluation of the disease is usually difficult. In this study, an arthritis model was successfully induced by injecting complete Freund’s adjuvant (CFA) into the toes of lower limbs of Wistar rats. Seven days after injection of CFA, obvious redness and swelling appeared at the toe joints of lower limbs accompanied by more sensitivity to thermal stimulation. Using the ultraweak bio-photon imaging system (UBIS) established by us, the toe joint area of the lower limbs of rats was imaged 7 days after injection of CFA. It was found that the volar part of lower limbs of arthritis rats showed significantly higher biophoton emissions compared with the control group. The results of this study may provide a basis for further research and devel-opment of early diagnosis and assessment of lesion progression of rheumatoid arthritis.

In radiofrequency ablation (RFA) treatment of cardiac arrhythmias, intraprocedural assessment of treatment efficacy relies on indirect measures of adequate tissue destruction. Direct sensing of diffuse reflectance spectral changes at the ablation site using optically integrated RFA catheters has been shown to enable accurate prediction of lesion dimensions, ex vivo. Challenges of optical guidance can be due to obtaining reliable measurements under various catheter-tissue contact orientations. In this work, addressed this limitation by assessing the feasibility of monitoring lesion progression using single-fiber reflectance spectroscopy (SFRS). A total of 110 endocardial lesions of various sizes were generated in freshly excised swine right ventricular tissue using a custom-built, irrigated SFRS-RFA catheter. Models were developed for assessing catheter-tissue contact, the presence of nontransmural or transmural lesions and lesion depth percentage. These results support the use of SFRS-based catheters for irrigated lesion assessment and motivate further exploration of using multi-SFRS catheters for omnidirectionality.

Oral anticoagulant and antiplatelet are often prescribed in clinical practice. These drugs are mainly consumed by geriatric patients to prevent or treat cerebrovascular, systemic embolism, or heart condition. Managing anticoagulated TBI patients is a challenging task for surgeons. This study aims to review available literatures regarding anticoagulated TBI patients and to suggest a treatment algorithm for such cases. Based on several retrospective and prospective studies, it might be wasteful to do a routine follow-up CT scan on anticoagulated TBI patients. The risk of new lesion development or presenting lesion progression seems to be especially low among patients with negative initial CT scan. We suggest to reserve repeat CT scan for patients with evident neurological deterioration. Tighter observation for anticoagulated patients with positive initial CT scan might be useful. Anticoagulation reversal is recommended by the American College of Cardiology, but some studies reported that reversal should be directed by INR. Acute antiplatelet cessation is still controversial for aspirin, but it is advised for clopidogrel. Preoperative management of both anticoagulant and antiplatelet should take into account the bleeding risk of the surgical procedure. Blind cessation and reversal of anticoagulant and/or antiplatelet might delay the timing of surgery and thus would better be avoided

Aims To identify the angiographic and clinical predictors of mild non-culprit coronary lesion (NCCL) progression in acute ST-elevation myocardial Infarction (STEMI). Methods and Results The present prospective cohort study evaluated 200 patients with acute STEMI underwent primary percutaneous coronary intervention (PPCI) (either PPCI or pharmaco-invasive PCI) divided into2groups based on whether the clinically driven non culprit lesion PCI existed or not into: Control group-1: 157 patients(78.5%) with non-progressed non culprit lesion (no additional PCI to the non-culprit lesion) and Study group-2: 43 patients(21.5%) with clinically driven non culprit lesion PCI (underwent additional PCI to progressed non-culprit lesions). Our study end point was the clinically driven non culprit lesion PCI (additional PCI to progressed non-culprit lesions). Asymptomatic patients were followed up by exercise ECG at 12 months and myocardial perfusion stress testing at 24 months. Multivariate regression analysis showed that the strongest independent predictor for progression of mild NCCL was complex morphology of culprit lesion (p Finally, a receiver operating characteristic (ROC) curve was performed to assess a cutoff value for predictors for NCCL progression after PPCI in Patients with STEMI. Conclusions Our novel angiographic independent predictor was complex morphology of culprit lesion. And our novel clinical independent predictors were CRP cutoff more than 7.05mg/l, peak cardiac troponin I value cutoff more than 27.5 ng/ml, and age cutoff less than 57.5 years, could be used for early prediction of mild NCCL progression after PPCI for acute STEMI patients. This could be used for early diagnosis to avoid repeated PCI and proper management for better outcomes.

BACKGROUND AND PURPOSE: White matter lesions of presumed ischemic origin are associated with progressive cognitive impairment and impaired BBB function. Studying the longitudinal effects of white matter lesion biomarkers that measure changes in perfusion and BBB patency within white matter lesions is required for long-term studies of lesion progression. We studied perfusion and BBB disruption within white matter lesions in asymptomatic subjects. MATERIALS AND METHODS: Anatomic imaging was followed by consecutive dynamic contrast-enhanced and DSC imaging. White matter lesions in 21 asymptomatic individuals were determined using a Subject-Specific Sparse Dictionary Learning algorithm with manual correction. Perfusion-related parameters including CBF, MTT, the BBB leakage parameter, and volume transfer constant were determined. RESULTS: MTT was significantly prolonged (7.88 [SD, 1.03] seconds) within white matter lesions compared with normal-appearing white (7.29 [SD, 1.14] seconds) and gray matter (6.67 [SD, 1.35] seconds). The volume transfer constant, measured by dynamic contrast-enhanced imaging, was significantly elevated (0.013 [SD, 0.017] minutes(−1)) in white matter lesions compared with normal-appearing white matter (0.007 [SD, 0.011] minutes(−1)). BBB disruption within white matter lesions was detected relative to normal white and gray matter using the DSC-BBB leakage parameter method so that increasing BBB disruption correlated with increasing white matter lesion volume (Spearman correlation coefficient = 0.44; P < .046). CONCLUSIONS: A dual-contrast-injection MR imaging protocol combined with a 3D automated segmentation analysis pipeline was used to assess BBB disruption in white matter lesions on the basis of quantitative perfusion measures including the volume transfer constant (dynamic contrast-enhanced imaging), the BBB leakage parameter (DSC), and MTT (DSC). This protocol was able to detect early pathologic changes in otherwise healthy individuals.

Background:Ischemic lesions commonly continue to progress even days after treatment, and this lesion growth is associated with unfavorable functional outcome in acute ischemic stroke patients. The aim of this study is to elucidate the role of edema in subacute lesion progression and its influence on unfavorable functional outcome by quantifying net water uptake.Methods:We included all 187 patients from the MR CLEAN trial who had high quality follow-up non-contrast CT at 24 h and 1 week. Using a CT densitometry-based method to calculate the net water uptake, we differentiated total ischemic lesion volume (TILV) into edema volume (EV) and edema-corrected infarct volume (ecIV). We calculated these volumes at 24 h and 1 week after stroke and determined their progression in the subacute period. We assessed the effect of 24-h lesion characteristics on EV and ecIV progression. We evaluated the influence of edema and edema-corrected infarct progression on favorable functional outcome after 90 days (modified Rankin Scale: 0–2) after correcting for potential confounders. Lastly, we compared these volumes between subgroups of patients with and without successful recanalization using the Mann–WhitneyU-test.Results:Median TILV increased from 37 (IQR: 18–81) ml to 68 (IQR: 30–130) ml between 24 h and 1 week after stroke, while the net water uptake increased from 22 (IQR: 16–26)% to 27 (IQR: 22–32)%. The TILV progression of 20 (8.8–40) ml was mostly caused by ecIV with a median increase of 12 (2.4–21) ml vs. 6.5 (2.7–15) ml of EV progression. Larger TILV, EV, and ecIV volumes at 24 h were all associated with more edema and lesion progression. Edema progression was associated with unfavorable functional outcome [aOR: 0.53 (0.28–0.94) per 10 ml;p-value: 0.05], while edema-corrected infarct progression showed a similar, non-significant association [aOR: 0.80 (0.62–0.99);p-value: 0.06]. Lastly, edema progression was larger in patients without successful recanalization, whereas ecIV progression was comparable between the subgroups.Conclusion:EV increases in evolving ischemic lesions in the period between 1 day and 1 week after acute ischemic stroke. This progression is larger in patients without successful recanalization and is associated with unfavorable functional outcome. However, the extent of edema cannot explain the total expansion of ischemic lesions since edema-corrected infarct progression is larger than the edema progression.

Dourine is an equine protozoan disease caused by Trypanosoma equiperdum. Dourine-afflicted animals die after developing neurological clinical signs, such as unilateral paresis. The disease has been a problem for many years; however, the pathogenesis regarding the neurological clinical signs of dourine has been unclear. In the present study, we conducted a histopathological examination in order to investigate the mechanisms by which dourine-afflicted horses develop the accompanying neurological clinical signs. Four dourine-afflicted horses in Mongolia were evaluated. An apparently healthy horse exhibited multifocal neuritis without axonal or myelin degeneration. The other horses, which had obvious neurological clinical signs, also exhibited multifocal neuritis. In particular, the nerves that innervated areas associated with neurological clinical signs exhibited neuritis with demyelination in the latter horses. Inflamed, non-demyelinating nerves were infiltrated with B lymphocytes and T lymphocytes; while inflamed, demyelinating nerves were infiltrated with mononuclear phagocytes. Our observations revealed lesion progression in the nerves, such that polyradiculoneuropathy could explain the accompanying neurological clinical signs of dourine. To our knowledge, this is the first report to describe a pathogenic mechanism for the development of the neurological clinical signs found in dourine-afflicted horses.

Background Spontaneous obliteration (SpO) of untreated arteriovenous malformations (AVMs) is rare with fewer than 100 cases reported. The incidence and predisposing factors of SpO remain unclear, impeding our understanding of lesion progression in untreated patients. Objective To determine the incidence rate and predisposing factors of SpO in a North American cohort. Methods AVMs were retrospectively evaluated at our institution for over 25 yr. Untreated AVMs were divided into 2 groups: SpO-AVMs and non-SpO-AVMs. All statistical results were based on univariate analyses. Incidence was generated from counts of SpO over the untreated interval in patient years from birth until obliteration, treatment, or last follow-up. Results One hundred fifty-four patients had untreated AVMs; SpO was observed in 4. Average ages were 49.0 ± 23.6 and 48.7 ± 20.4 yr in the SpO-AVM and non-SpO-AVM group, respectively (P = .98). Average AVM sizes were 2.0 ± 1.8 cm (SpO-AVMs) and 3.7 ± 2.6 cm (non-SpO-AVMs, P = .25). All SpO-AVMs and 40 (27.0%) non-SpO-AVMs had a ruptured presentation (P = .006). A single draining vein was observed in all SpO-AVMs and 39 (32.8%) non-SpO-AVMs (P = .01). Deep venous drainage was not observed in any SpO-AVMs, but in 81 (57.9%) non-SpO-AVMs (P = .04). Mean follow-up time was 37.0 ± 42.6 and 75.6 ± 161.7 mo in SpO-AVM and non-SpO-AVMs patients, respectively. Of the 2 SpO-AVM patients with postobliteration follow-up, 1 experienced recanalization. From a 672-patient cohort, the incidence of SpO over 28 961 patient years was 0.014%. Conclusion SpO-AVMs have an annual incidence rate of approximately 0.014% and tend to present with rupture, a single draining vein, and superficial venous drainage. Expectation of SpO for untreated AVMs is not justified, and patients should anticipate life-long hemorrhagic risk for untreated AVMs.

Article Title and Bibliographic Information The International Caries Detection and Assessment System–ICDAS: A Systematic Review. Ekstrand KR, Gimenez T, Ferreira FR, Mendes FM, Braga MM. Caries Res 2018; 52:406-419. Source of Funding Government FAPESP, the Sao Paulo Research Foundation (FAPESP 2012/17888-1 and 2014/00271-7) and the Brazilian National Council for Scientific and Technological Development (CNPq) (400736/2014-4) Type of Study/Design Systematic review with meta-analysis of data

Aim The treatment of white lesions should aim at arresting the lesion progression of carious lesions and improving the esthetics by diminishing the opacity of the developmental disturbances of a tooth. The objective of this review was to present the scientific basis, the principles of resin infiltration and to discuss its inherent clinical applications. Data sources Data were identified by PubMed searches. Papers published in English between 2010 and 2015 were selected and most up-to-date or relevant references were chosen. Conclusion The resin infiltration technique, while promising, needed more clinical evidence for conclusive findings. However, based on available laboratory and clinical studies, it seems convincing that resin infiltration of enamel lesions should aim at arresting the progression of white spot lesions. Combining this microinvasive approach with a substantial caries remineralization program may provide therapeutic benefits and significantly reduce both long term restorative needs and costs, thus complementing the concept of minimum intervention dentistry. How to cite this article Manoharan V, Kumar AS, et al. Is Resin Infiltration a Micro invasive Approach to White Lesions of Calcified Tooth Structures?: A Systemic Review. Int J Clin Pediatr Dent 2019;12(1):53–58.

Equine clinicians and researchers often make the diagnosis of equine sarcoids (ES) on clinical assessment alone, without histopathological confirmation. However, the accuracy of the clinical diagnosis of ES has not been critically assessed. To assess sensitivity, specificity, positive and negative predictive values of the clinical diagnosis of ES, 40 clinical cases with histologically confirmed equine skin lesions (26 ES and 14 non-ES) were compiled in a representative online examination. For each case and lesion, at least one photograph and all relevant information were presented in a standardised format. This included the horse's signalment, lesion localisation, lesion progression, presence of other skin lesions, earlier treatments and response to treatment. No information relevant for the assessment of the lesion was intentionally withheld. Fourteen ES experts, 39 board-certified equine specialists, 103 equine practitioners and 25 novices categorised the cases into ES or non-ES and graded their level of diagnostic confidence on a scale from 1 to 6 for each case. The overall success rate was 82.0% while sensitivity and specificity were 83.3% and 79.6%, respectively. The positive and negative predictive values were 88.4% and 72.0%, respectively, in the tested population with a 66% prevalence of ES. However, less experienced veterinarians were frequently wrong in their clinical judgement despite a high level of diagnostic confidence. Therefore, the authors propose to develop a diagnostic tool to help clinicians optimise their selection of lesions requiring a biopsy. Ultimately, this will help reduce costs and morbidity generated by unnecessary diagnostic and therapeutic efforts.

Minimally invasive dentistry is based on conservative techniques for the treatment of initial caries lesions, the so-called white spot lesions. One of the conservative maneuvers includes the use of enamel resin infiltrant: a low viscosity material that penetrates the enamel pores to stop lesion progression. Aim: Therefore, this case report aimed to describe the clinical case of a 28-year-old female patient under routine consultation, in which a radiographic examination showed the presence of two incipient caries lesions in the left upper premolars. Methods: The application of a resin infiltrating agent (Icon®, DMG – Hamburg, Germany) was chosen as treatment to stop caries lesions progression. Conclusion: The use of this conservative technique can be considered a promising approach for the prevention of dental tissue wear, and the resin infiltrant is considered an effective material.

Background: Most of cardiovascular (CV) events in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI) are linked to the progression of non-culprit coronary lesions (NCCLs) during the follow-up period. Yet, the clinical and angiographic risk factors of non-culprit coronary lesion (NCCL) progression are not well known. Objectives: To assess the clinical risk profile and angiographic features that can be related to the progression of non-culprit lesions (NCLs) of patients with STEMI undergoing PCI over 24 months duration.Subjects and methods: The present cohort study evaluated 200 patients with STEMI underwent PCI to the culprit lesion and have mild non culprit lesion (NCL) 1.4mmol/L) (OR:54.656, 95% CI: 4.052 to 737.256; p= 0.003), Complex culprit lesion(OR:296.112, 95% CI: 13.673 to 6412.728; p < 0.001), and presence of more than one NCL (OR:22.447, 95% CI: 2.521 to 199.849; p= 0.005). Conclusion: The underlying clinical and angiographic characteristics can predict NCLs progression. Complex morphology of culprit lesion is the strongest independent predictor for progression of NCLs.

Patients with cardiac arrythmia most commonly require radiofrequency ablation to destroy arrhythmogenic electrical pathways and restore normal heart rhythm. However, arrhythmia resurgence exists from limited means to directly confirm the extent of lesion progression during RFA procedure. Optical spectroscopy is sensitive to tissue optical properties and changes in biomolecular composition. We propose a simplified optical spectroscopy through a single fiber integrated catheter to predict irrigated endocardial lesion progression using deep neural network model on ex-vivo model.

Objetivo: Evaluar la efectividad del sellado de lesiones de caries dental no cavitadas. Materiales y Métodos: Se realizó un ensayo clínico, aleatorio, doble ciego, controlado y diseño de boca dividida. Fueron seleccionados 262 primeros molares permanentes, en 74 niños con edad media de 7,47±0.8 años. Cada paciente tenía mínimo un par de primeros molares permanentes con lesiones bilaterales de caries dental códigos 1, 2 o 3 del Sistema Internacional de Detección y Valoración de Caries Dental. Se asignaron aleatoriamente a tres tipos de tratamiento, 1: vidrio ionomérico (3M ESPE Ketac Molar Easymix®), 2: Sellante resinoso (3M ESPE Climpro®), 3: vidrio ionomérico modificado con resina (3M ESPE Ketac® N100). La retención y progresión de caries dental fueron evaluadas. Los datos se procesaron con el programa SPSS V15. Se utilizaron las pruebas Chi Cuadrado y Test de Fisher. Resultados: La tasa retención total de los tratamientos 1, 2 y 3 fue respectivamente: 51,7%, 43,4% y 26,4%; no obstante estas diferencias no fueron significativas. La incidencia de caries en los molares no sellados fue 31,8% y en los molares sellados con perdida completa del material 28,5%. No se encontraron diferencias significativas en la progresión de las lesiones entre molares que reciben y los que no reciben tratamiento. Conclusiones: En este estudio, no se encontraron evidencias de diferencias en la retención y en la progresión de las lesiones selladas y no selladas, entre el vidrio ionomérico convencional de alta densidad, el sellante a base de resina y un vidrio ionomérico modificado con resina.

Objective: T o compare the survival of occlusal and occlusal-proximal restorations performed with resin-modified glass-ionomer cement (RMGIC) in deciduous molars using rubber dam and cotton rolls isolation . Material and Methods: Ninety-two patients were included and 200 deciduous molars with cavitated occlusal or occlusoproximal dentin caries lesions were randomized into two groups: cotton rolls (n = 100) and rubber dam (n = 100) and RMGIC restorations were placed. At baseline and in the follow-up visit, presence, severity and activity of caries lesions were registered. Two independent, blinded examiners evaluated the treated teeth clinically using the USPHS criteria and radiographically after 9 months. Descriptive analysis, survival curve (log-rank test) and Cox regression were performed to assess risk factors related to failure. Results: Out of the 179 teeth (92 cotton rolls group and 87 rubber dam group) evaluated at 9-month follow-up period. No lesion progression was observed radiographically. The overall treatment success rate was 85.47% (83.47% for cotton rolls and 87.35 rubber dam group). No significant difference between isolation methods was observed in the log-rank test (p = 0.16). Cox regression showed no risk factors related to failure . Conclusion: No difference was found in the survival of occlusal and occlusal-proximal restorations performed with RMGIC in deciduous molars using a rubber dam and cotton rolls isolation after a 9-month follow-up period.

Introduction: Chronic durable lesions after radiofrequency ablation (RFA) of myocardial tissue remain difficult to achieve. Tissue exposed to RFA will often recover electrical activity despite initial dormancy. Heat sensitive liposomes (HSL) carrying doxorubicin has been shown to enhance RF destruction of tumors. Hypothesis: We sought to evaluate whether HSL doxorubicin will improve myocardial RFA lesion durability. Methods: Using an in vivo porcine model, 3 linear RF ablations per animal were performed by blinded operators in the right atrium after systemic HSL doxorubicin infusion or saline control: posterior (20W), septal (30W), and lateral (40W). Each line was created under standardized 3D mapping settings with inter-lesion distances of 4-6 mm to intentionally simulate linear RF gaps. Voltage mapping was performed immediately after ablation (Day 0) and after 2 weeks of survival. Comparisons were made in linear low voltage areas (LVA) from Day 0 to 2 weeks. Pathological staining of porcine RA ablation was also performed to assess for histological linear gaps. Results: There was no immediate difference in Day 0 LVA < 0.5 mV after ablation for HSL and controls. However, a significant increase in LVA < 0.5 mV was observed at 2 weeks in HSL animals (figure) with lesion progression in 3/5, compared to 0/4 controls, p< 0.05. There were fewer gaps identified with voltage remapping and on histology for HSL subjects compared to controls. Conclusions: RFA with concurrent HSL doxorubicin will be more durable and result in lesion progression with fewer linear gaps over time. Further confirmatory studies are needed.

Atherosclerosis is a major arterial disease characterized by the thickening of the arteries’ walls. The development of stenosis at the carotid bifurcation affects the local variations in blood flow dynamic factors. The carotid artery dynamic factors: including the wall shear stress (WSS), time-averaged wall shear stress (TAWSS) and pressure gradient affect the rate of progression of the stenosis. It is essential to analyze the flow in three-dimensional reconstructed patient-specific geometries with realistic boundary conditions to estimate the blood flow dynamic factors. Hence, a three-dimensional comprehensive model is developed including the non-Newtonian blood flow under pulsatile flow conditions. The model is numerically simulated using computational fluid dynamics solvers along with the medical imaging to investigate the effect of stenosis locations on its progression. The numerically predicted blood flow dynamic factors are analyzed. It was found that the blood flow dynamic factors have the importance to influence the diagnosis and prediction of asymptomatic carotid artery stenosis progression. Based on results, the value of TAWSS at the stenosis in the stenotic Common Carotid Artery (CCA) is 46.68 Pa comparing to 19.24 Pa and 10.049 Pa in Internal Carotid Artery (ICA) and External Carotid Artery (ECA) respectively. Also, it was found that the maximum value of WSS in the healthy artery at the bifurcation with 3.829 Pa. However, in stenotic arteries the maximum value for WSS located at the stenosis throat which was found to be 102.158 Pa for CCA comparing to 46.859 Pa in ICA and 33.658 Pa in ECA.

First described by the French surgeon Maurice Morel-Lavallee in 1853, Morel-Lavallee syndrome (MLS) is a serolymphatic effusion resulting from tangential injury to richly vascularized tissues. The imaging characteristics may be variable over time due to lesion progression and the eventual organization of a fibrous capsule. We report a case of extensive MLS in the lower leg of a 12-year-old child. We discuss the ultrasound and magnetic resonance imaging findings and describe the differential diagnoses. LEARNING POINTS The diagnosis of Morel-Lavallee syndrome is based on clinical examination and imaging techniques. The post-traumatic context is important for diagnosis. Morphological aspects depend on lesion progression and the eventual organization of a fibrous capsule.

The endangered corals Orbicella annularis and O. faveolata are crucial to Caribbean reefs because of their large size and contribution to reef framework. The objective of this study was to describe the prevalence and progression of macroscopically evident lesions affecting Orbicella spp. in shallow fringing reefs in St. Kitts. Cross-sectional surveys in the spring of 2017 demonstrated 8 predominant lesion patterns affecting 59% of corals (95% CI: 55.8-62.1%), including annular yellow-brown pigmentation, focal brown pigmentation, focal bleaching, diffuse bleaching, annular black surface deposit, focal tissue loss with skeletal erosion, focal grey pigmentation, and growth anomaly. Longitudinal surveys of 47 tagged corals were performed from August 2016-May 2017 to track lesion progression. The 2 most common lesions, annular yellow-brown pigmentation (n = 30), and focal brown pigmentation (n = 21), showed mean (±SD) partial colony mortality growth of 0.26 ± 0.5 and 0.21 ± 0.45 cm2 d-1, respectively. Annular pigmentation progression severity was associated with a marginating band of bleaching (ordinal odds ratio [OOR] = 11.0), and yellow rather than brown color (OOR = 3.8). Bleaching lesions (n = 13), occurring during a time of elevated sea surface temperature, were most severe during October-December 2016, and persisted through April 2017, months after heat stress had subsided. Annular black surface deposits (n = 3) were associated with rapid progression of acute tissue loss, whereas focal tissue loss with skeletal erosion (n = 2) regressed within months, and focal grey pigmentation (n = 2) was quiescent for the length of the study. This study enforces concern for the extent to which Orbicella spp. are declining due to disease.

OBJECTIVES This study explored whether the pattern of nonobstructive lesion progression into obstructive lesions would differ according to the presence of high-risk plaque (HRP).BACKGROUND It is still debatable whether HRP simply represents a certain phase during the natural history of coronary atherosclerotic plaques or if disease progression would differ according to the presence of HRP.METHODS Patients with nonobstructive coronary artery disease, defined as percent diameter stenosis (%DS) = 2 years. HRP was defined as lesions with >= 2 features of positive remodeling, spotty calcification, or low-attenuation plaque. Quantitative total and compositional percent atheroma volume (PAV) at baseline and annualized PAV change were compared between non-HRP and HRP lesions.RESULTS A total of 3,049 nonobstructive lesions were identified from 1,297 patients (mean age 60.3 +/- 9.3 years; 56.8% men). There were 2,624 non-HRP and 425 HRP lesions. HRP lesions had a greater total PAV and all noncalcified components of PAV and %DS at baseline compared with non-HRP lesions. However, the annualized total PAV changes were greater in non-HRP lesions than in HRP lesions. On multivariate analysis adjusted for clinical risk factors, drug use, change in lipid level, total PAV, %DS, and HRP, only the baseline total PAV and %DS independently predicted the development of obstructive lesions (hazard ratio [HR]: 1.04; 95% confidence interval [CI]: 1.02 to 1.07, and HR: 1.07; 95% CI: 1.04 to 1.10, respectively, all p < 0.05), whereas the presence of HRP did not (p > 0.05).CONCLUSIONS The pattern of individual coronary atherosclerotic plaque progression differed according to the presence of HRP. Baseline PAV, not the presence of HRP features, was the most important predictor of lesions developing into obstructive lesions. (Progression of Atherosclerotic Plaque Determined By Computed Tomographic Angiography Imaging [PARADIGM]; NCT02803411) (c) 2020 by the American College of Cardiology Foundation.

Colorectal cancer is the largest cause of cancer deaths for both men and women, hence early detection of polyps plays an important role for survival. Despite the advancement of the state-of-the-art in the context of objects detection, methods suffer in recognising small polyps, which are the most important to detect since are the one appearing at the beginning of the lesion progression. To deal with the detection of small polyps, we propose to reorganise the training procedure of an object detection in a hierarchical way such that it can better consider visual colonoscopy images content and size polyp variability. Due to the small size of the datasets publicly available in this context, and considering that current datasets do not have an adequate variability to properly assess the performances of a polyp detector, for this study we have collected a new large scale dataset which have been labelled by colonoscopy experts during a clinical trial. The employed dataset is an order of magnitude larger than the datasets currently available in literature and it is better suited to perform more appropriate benchmark of polyps detection since it has been acquired with different colonoscopy devices and because contain a high number of different polyps with real variability in appearance and size. Experimental results on this novel large dataset point out that, by considering the polyps size variability in a hierarchical fine-tuning, polyps can be detected with very high per-frame and per-polyp F 1 score of 78.56% and 95.60% respectively.

Laser ablation (LA) is a promising approach for minimally invasive cancer treatments. Its in vivo applicability is often impeded by the lack of efficient monitoring tools that can help to minimize collateral tissue damage and aid in determining the optimal treatment end-points. We have devised a new, to the best of our knowledge, hybrid LA approach combining simultaneous volumetric optoacoustic (OA) imaging to monitor the lesion progression accurately in real time and 3D. Time-lapse imaging of laser ablation of solid tumors was performed in a murine breast cancer model in vivo by irradiation of subcutaneous tumors with a 100 mJ short-pulsed ( ∼ 5 n s ) laser operating at 1064 nm and 100 Hz pulse repetition frequency. Local changes in the OA signal intensity ascribed to structural alterations in the tumor vasculature were clearly observed, while the OA volumetric projections recorded in vivo appeared to correlate with cross sections of the excised tumors.

Objective: To verify the effectiveness of sealing with glass ionomer cement and transversal brushing in the prevention and treatment of initial caries lesions in erupting permanent molars of children aged 5-7 years. Material and Methods: Healthy teeth with ICDAS scores 1 or 2 were selected. One hundred and thirty-one children (79 teeth in the control group - 75 teeth in the test group) were randomly assigned into the two experimental groups: (1) transversal brushing technique for plaque control with conventional flat bristles and fluoridated dentifrice or (2) sealing the occlusal surfaces with glass ionomer cement (Vitro Molar ® ). Follow-up was performed for 18 months and the survival analysis was applied to test the occurrence of lesion progression. Results: The mean age of children was 5.4 years and it was verified that, by examining the initial tooth condition, the probability of progression was 66% lower when the tooth had initial caries lesions than when it was healthy; the probability of molar progression was about 74% lower in the test group compared to the control group. The mean time for lesion development in the test group (16.8 months; SD = 0.5) was greater than that in the control group (16.5 months; SD = 0.5; p=0.008). Conclusion: Sealing reduces the progression of caries disease in initial lesions when compared to the transversal brushing technique.

Article Title and Bibliographic Information A randomized controlled trial of caries prevention in dental practice. Tickle M, O'Neill C, Donaldson M, Birch S, Noble S, Killough S, Murphy L, Greer M, Brodison J, Verghis R, Worthington HV. J Dent Res 2017; 96:741-46. Source of Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme in UK. Type of Study/Design Randomized clinical trial with a parallel design.