Advanced Atrophy Research Articles

Assessment of retinal atrophy in mixed breed dogs using spectral domain optical coherence tomography (SD-OCT) and electroretinography.

The aim of the study was to characterize retinal atrophy (RA) with progressive retinal atrophy symptoms in mixed breed dogs using ophthalmoscopy, spectral domain optical coherence tomography (SD-OCT) and electroretinography (ERG).The study was performed on 13 mixed breed dogs affected by retinal atrophy (11 males and 2 females that were 1.5-14 years old). Depending on the advancement of RA, SD-OCT examinations identified retinal abnormalities ranging from layer disorganisation to advanced atrophy. The most advanced RA occurred ventral to the optic disc. Total retinal thickness in both eyes (mean ± SD) was lower in dogs with RA compared to controls dorsally (77.7 ± 39.5 μm vs 173.5 ± 13.3 μm), ventrally (33.4 ± 29.9 μm vs 139.5 ± 10.8 μm), nasally (65.0 ± 34.5 μm vs 163.9 ± 11.0 μm) and temporally (61.8 ± 41.7 μm vs 171.9 ± 11.1 μm) to the optic disc. In dogs with locally normal architecture of inner retina, loss of definition of outer retinal layers occurred in many regions. Dark and light-adapted ERGs were reduced in 2 dogs with RA and were unrecordable in 11 dogs. Lesions evident in SD-OCT scans of mixed breed dogs affected with retinal atrophy initially appear ventrally to the optic disc and ventro-dorsally in advanced RA. In all mixed breed dogs with retinal atrophy, clinical signs and SD-OCT results correlate with ERG findings.

A generalizable data-driven model of atrophy heterogeneity and progression in memory clinic settings.

Memory clinic patients are a heterogeneous population representing various aetiologies of pathological ageing. It is not known whether divergent spatiotemporal progression patterns of brain atrophy, as previously described in Alzheimer's disease patients, are prevalent and clinically meaningful in this group of older adults. To uncover distinct atrophy subtypes, we applied the Subtype and Stage Inference (SuStaIn) algorithm to baseline structural MRI data from 813 participants enrolled in the DELCODE cohort (mean ± standard deviation, age = 70.67 ± 6.07 years, 52% females). Participants were cognitively unimpaired (n = 285) or fulfilled diagnostic criteria for subjective cognitive decline (n = 342), mild cognitive impairment (n = 118) or dementia of the Alzheimer's type (n = 68). Atrophy subtypes were compared in baseline demographics, fluid Alzheimer's disease biomarker levels, the Preclinical Alzheimer Cognitive Composite (PACC-5) as well as episodic memory and executive functioning. PACC-5 trajectories over up to 240 weeks were examined. To test whether baseline atrophy subtype and stage predicted clinical trajectories before manifest cognitive impairment, we analysed PACC-5 trajectories and mild cognitive impairment conversion rates of cognitively unimpaired participants and those with subjective cognitive decline. Limbic-predominant and hippocampal-sparing atrophy subtypes were identified. Limbic-predominant atrophy initially affected the medial temporal lobes, followed by further temporal regions and, finally, the remaining cortical regions. At baseline, this subtype was related to older age, more pathological Alzheimer's disease biomarker levels, APOE ε4 carriership and an amnestic cognitive impairment. Hippocampal-sparing atrophy initially occurred outside the temporal lobe, with the medial temporal lobe spared up to advanced atrophy stages. This atrophy pattern also affected individuals with positive Alzheimer's disease biomarkers and was associated with more generalized cognitive impairment. Limbic-predominant atrophy, in all participants and in only unimpaired participants, was linked to more negative longitudinal PACC-5 slopes than observed in participants without or with hippocampal-sparing atrophy and increased the risk of mild cognitive impairment conversion. SuStaIn modelling was repeated in a sample from the Swedish BioFINDER-2 cohort. Highly similar atrophy progression patterns and associated cognitive profiles were identified. Cross-cohort model generalizability, at both the subject and the group level, was excellent, indicating reliable performance in previously unseen data. The proposed model is a promising tool for capturing heterogeneity among older adults at early at-risk states for Alzheimer's disease in applied settings. The implementation of atrophy subtype- and stage-specific end points might increase the statistical power of pharmacological trials targeting early Alzheimer's disease.

Characteristic endoscopic findings in early-stage autoimmune gastritis.

Background and study aims Until recently, autoimmune gastritis (AIG) was usually diagnosed at late stages based on typical endoscopic findings, including corpus-dominant advanced atrophy. Early-stage AIG prior to complete gastric atrophy had rarely been diagnosed due to a lack of knowledge about its endoscopic characteristics. The present study sought to identify the endoscopic characteristics of early-stage AIG, enabling its early diagnosis. Patients and methods The clinical and endoscopic findings of 12 patients diagnosed with early-stage AIG between 2016 and 2021 were retrospectively evaluated. Patients were included if they were: (1) positive for serum anti-parietal cell antibody; (2) diagnosed with histological early-stage AIG; and (3) endoscopically positive for folds on the greater curvature of the gastric corpus. Results Two characteristic endoscopic findings of early-stage AIG were identified: longitudinal alignment of pseudopolyps (i.e., a bamboo joint-like appearance) and swelling of gastric areas with erythema (i.e., a salmon roe-like appearance). Conclusions Endoscopic findings characteristic of early-stage AIG include a bamboo joint-like appearance and a salmon roe-like appearance. Studies in large numbers of patients with long-term follow-up are needed to confirm these findings.

Education, wealth, and survival after dementia diagnosis

AbstractBackgroundThe relationship between socio‐economic status (SES) and length of life after dementia diagnosis may vary by specific aspects of SES. Education and wealth, two widely used measures of SES, may extend life expectancy via greater efficiency of health investment and better access to care. However, according to the cognitive reserve hypothesis, education protects against dementia pathology and thus when dementia symptoms manifest, individuals with higher education have more advanced atrophy, likely shortening their post‐dementia life expectancy. This paper examined education and wealth disparities in 1) timing of dementia diagnosis, 2) length of life after diagnosis, and 3) use of healthcare after diagnosis as a potential mechanism through which education and wealth differentially influence survival.MethodData was extracted from the Health and Retirement Study (HRS) linked to Medicare claims. From claims we identified 2,377 individuals with incident dementia diagnosis between 2000 and 2016 and followed them for up to 18 years. Using Cox proportional hazard models, we estimated relationships between education, household wealth, and mortality, adjusting for demographics, comorbidity, function, and cognition at the time of dementia diagnosis. To test whether SES disparities were driven by healthcare utilization, we ran linear regressions on the number of emergency room (ER) visits, inpatient admissions, and office visits after diagnosis with the same set of predictors.ResultIndividuals with higher education and wealth exhibited less functional and cognitive impairment at dementia diagnosis. The protective effect of higher education on mortality was absorbed by controlling for wealth. In the fully adjusted model, ranking in the top quartile of wealth was associated with a 17% reduction in mortality risk (HR = 0.83, 95% CI: 0.72‐0.96), relative to the bottom quartile. Wealth was not associated with ER visits, hospitalization, or office visits.ConclusionMore intact function and cognition at incident diagnosis did not confer longer survival for the highly educated. In contrast, the most affluent experienced a lower mortality risk, which was unrelated to healthcare utilization. While more research is warranted to understand pathways, these disparities inform opportunities for achieving health equities among persons living with dementia, by targeting at those with limited financial resources.

RBP3-Retinopathy—Inherited High Myopia and Retinal Dystrophy: Genetic Characterization, Natural History, and Deep Phenotyping

To examine the genetic and clinical features and the natural history of RBP3-associated retinopathy. Multi-center international, retrospective, case series of adults and children, with moleculraly confirmed RBP3-asociated retinopathy. The genetic, clinical, and retinal imaging findings, including optical coherence tomography (OCT) and fundus autofluorescence (FAF), were investigated both cross-sectionally and longitudinally. The results of international standard full-field electroretinography (ERG) and pattern electroretinography (PERG) were reviewed. We ascertained 12 patients (5 female and 7 male) from 10 families (4 patients previously reported). Ten novel disease-causing RBP3 variants were identified. Ten patients were homozygous. The mean age (±SD, range) of the group was 21.4 years (±19.1, 2.9-60.5 years) at baseline evaluation. All 12 patients were highly myopic, with a mean spherical equivalent of -16.0D (range, -7.0D to -33.0D). Visual acuity was not significantly different between eyes, and no significant anisometropia was observed. Mean best-corrected visual acuity (BCVA) was 0.48 logMAR (SD, ±0.29; range, 0.2-1.35 logMAR); at baseline. Eleven patients had longitudinal BCVA assessment, with a mean BCVA of 0.46 logMAR after a mean follow-up of 12.6 years. All patients were symptomatic with reduced VA and myopia by the age of 7 years old. All patients had myopic fundi and features in keeping with high myopia on OCT, including choroidal thinning. The 4 youngest patients had no fundus pigmentary changes, with the rest of the patients presenting with a variable degree of mid-peripheral pigmentation and macular changes. FAF showed variable phenotypes, ranging from areas of increased signal to advanced atrophy in older patients. OCT showed cystoid macular edema at presentation in 3 patients, which persisted during follow-up in 2 patients and resolved to atrophy in the third patient. The ERGs were abnormal in 9 of 9 cases, revealing variable relative involvement of rod and cone photoreceptors with additional milder dysfunction post-phototransduction in some. All but 1 patient had PERG evidence of macular dysfunction, which was severe in most cases. This study details the clinical and functional phenotype of RBP3-retinopathy in the largest cohort reported to date. RBP3-retinopathy is a disease characterized by early onset, slow progression over decades, and high myopia. The phenotypic spectrum and natural history as described herein has prognostic and counseling implications. RBP3-related disease should be considered in children with high myopia and retinal dystrophy.

Outcomes of Zygomatic Implants Combined with Anterior Regular Implants: A Retrospective Analysis with a Mean Follow-up Time of 36 Months.

Purpose: To retrospectively evaluate the clinical outcomes of immediately loaded zygomatic implants combined with anterior regular implants (hybrid zygoma) for the fixed rehabilitation of atrophic maxillae. Materials and Methods: A total of 18 patients were enrolled in this study and treated with the hybrid zygoma concept by an experienced surgeon. Follow-up visits were planned after 1 week, 3 weeks, 4 months, 6 months, then annually. At the last follow-up appointment (mean: 36 months after surgery; range: 24 to 52 months), the prostheses were unscrewed and the implants and peri-implant tissues were examined. The primary outcome evaluated was implant success. Following the criteria proposed by Aparicio et al, implant success was classified in five grades, with grade I representing the best condition and grade V representing a failure. At the annual check-up, patients were asked to fill out a questionnaire to evaluate their satisfaction with their oral rehabilitation. Results: A total of 80 implants (34 zygomatic and 46 regular) were inserted. One zygomatic implant was lost in one patient, and two regular implants failed in two other patients. Of the zygomatic implants, 24 (70.6%) presented a success grade I, 9 (26.5%) a success grade II, and 1 (2.9%) a grade V. Sinusitis was the most common biologic complication, occurring in two patients (5.6%). Two patients showed unilateral upper lip paresthesia that was persistent at the last follow-up appointment. According to the annual follow-up visit questionnaire data, 72%, 89%, and 94% of patients declared that they were satisfied with their phonetic ability, chewing ability, and esthetics, respectively. Conclusion: Although zygomatic implants combined with anterior regular implants present a higher risk of complications than traditional implantology, they allow for immediately loaded full-arch fixed rehabilitation of patients with advanced atrophy of the posterior maxilla, which provides satisfactory chewing ability, esthetics, and phonetics.

RP2-Associated X-linked Retinopathy: Clinical Findings, Molecular Genetics, and Natural History

To review and describe in detail the clinical course, functional and anatomic characteristics of RP2-associated retinal degeneration. Retrospective case series. Male participants with disease-causing variants in the RP2 gene. Review of all case notes and results of molecular genetic testing, retinal imaging (fundus autofluorescence [FAF] imaging, OCT), and electrophysiology assessment. Molecular genetic testing, clinical findings including best-corrected visual acuity (BCVA), qualitative and quantitative retinal imaging analysis, and electrophysiology parameters. Fifty-four molecularly confirmed patients were identified from 38 pedigrees. Twenty-eight disease-causing variants were identified, with 20 not previously clinically characterized. Fifty-three patients (98.1%) presented with retinitis pigmentosa. The mean age of onset (range ± standard deviation [SD]) was 9.6 years (1-57 ± 9.2 years). Forty-four patients (91.7%) had childhood-onset disease, with mean age of onset of 7.6 years. The most common first symptom was night blindness (68.8%). Mean BCVA (range ± SD) was 0.91 logarithm of the minimum angle of resolution (logMAR) (0-2.7 ± 0.80) and 0.94 logMAR (0-2.7 ± 0.78) for right and left eyes, respectively. On the basis of the World Health Organization visual impairment criteria, 18 patients (34%) had low vision. The majority (17/22) showed electroretinogram (ERG) evidence of a rod-cone dystrophy. Pattern ERG P50 was undetectable in all but 2 patients. A range of FAF findings was observed, from normal to advanced atrophy. There were no statistically significant differences between right and left eyes for ellipsoid zone width (EZW) and outer nuclear layer (ONL) thickness. The mean annual rate of EZW loss was 219 μm/year, and the mean annual decrease in ONL thickness was 4.93 μm/year. No patient with childhood-onset disease had an identifiable ellipsoid zone (EZ) after the age of 26 years at baseline or follow-up. Four patients had adulthood-onset disease and a less severe phenotype. This study details the clinical phenotype of RP2 retinopathy in a large cohort. The majority presented with early-onset severe retinal degeneration, with early macular involvement and complete loss of the foveal photoreceptor layer by the third decade of life. Full-field ERGs revealed rod-cone dystrophy in the vast majority, but with generalized (peripheral) cone system involvement of widely varying severity in the first 2 decades of life. Proprietary or commercial disclosure may be found after the references.

Endoscopic Features of Autoimmune Gastritis: Focus on Typical Images and Early Images.

Autoimmune gastritis (AIG) is chronic atrophic gastritis caused by an autoimmune mechanism of unknown etiology and presents with various pathological conditions by causing an achlorhydria state through parietal cell damage. The most characteristic endoscopic finding in AIG is advanced corpus-dominant mucosal atrophy. A recent study that examined several cases in Japan revealed the presence of endoscopic features other than corpus-dominant advanced atrophy. Remnants of oxyntic mucosa and sticky adherent dense mucus were found in ≥30% of cases, and hyperplastic polyps were found in ≥20% of cases. In image-enhanced endoscopy (IEE), white globe appearance (WGA) was observed in 32% of AIG cases. Additionally, some reports have stated that the findings in AIG cases using IEE showed cast-off skin appearance (CSA) and foveola type mucosa; however, a consensus is yet to be achieved. These endoscopic results were found in cases of advanced-stage AIG. There have been few reports concerning early-stage AIG cases. In these few reports, all of the cases were pathologically diagnosed as early AIG. In all of the cases, the pathological findings almost always showed neither parietal cell destruction nor atrophy. Endoscopic findings such as “mosaic pattern with slight swelling of the areae gastricae”, “diffuse reddened and edematous gastric fundic gland mucosa”, and “pseudopolyp-like nodules” may be common characteristics of early images. In such early cases, high antibody titers, no atrophic changes, and few clinical abnormal findings were shown. Endoscopists are expected to update their knowledge regarding AIG diagnosis with the evolution of imaging equipment.

Innate Immune Cell-Related Pathology in the Thalamus Signals a Risk for Disability Progression in Multiple Sclerosis.

Background and ObjectivesOur aim was to investigate whether 18-kDa translocator protein (TSPO) radioligand binding in gray matter (GM) predicts later disability progression in multiple sclerosis (MS).MethodsIn this prospective imaging study, innate immune cells were investigated in the MS patient brain using PET imaging. The distribution volume ratio (DVR) of the TSPO-binding radioligand [11C]PK11195 was determined in 5 GM regions: thalamus, caudate, putamen, pallidum, and cortical GM. Volumetric brain MRI parameters were obtained for comparison. The Expanded Disability Status Scale (EDSS) score was assessed at baseline and after follow-up of 3.0 ± 0.3 (mean ± SD) years. Disability progression was defined as an EDSS score increase of 1.0 point or 0.5 point if the baseline EDSS score was ≥6.0. A forward-type stepwise logistic regression model was constructed to compare multiple imaging and clinical variables in their ability to predict later disability progression.ResultsThe cohort consisted of 66 patients with MS and 18 healthy controls. Patients with later disability progression (n = 17) had more advanced atrophy in the thalamus, caudate, and putamen at baseline compared with patients with no subsequent worsening. TSPO binding was significantly higher in the thalamus among the patients with later worsening. The thalamic DVR was the only measured imaging variable that remained a significant predictor of disability progression in the regression model. The final model predicted disability progression with 52.9% sensitivity and 93.9% specificity with an area under the curve value of 0.82 (receiver operating characteristic curve).DiscussionIncreased TSPO radioligand binding in the thalamus has potential in predicting short-term disability progression in MS and seems to be more sensitive for this than GM atrophy measures.

Influence of brain atrophy using semiquantitative analysis in [123I]FP-CIT single-photon emission computed tomography by a Monte Carlo simulation study

The specific binding ratio (SBR) is an objective indicator of N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-[123I] iodophenyl) nortropane ([123I]FP-CIT) single-photon emission computed tomography (SPECT) that could be used for the diagnosis of Parkinson’s disease and Lewy body dementia. One of the issues of the SBR analysis is that the setting position of the volume of interest (VOI) may contain cerebral ventricles and cerebral grooves. These areas may become prominent during the brain atrophy analysis; however, this phenomenon has not been evaluated enough. This study thus used Monte Carlo simulations to examine the effect of brain atrophy on the SBR analysis. The brain atrophy model (BAM) used to simulate the three stages of brain atrophy was made using a morphological operation. Brain atrophy levels were defined in the descending order from 1 to 3, with Level 3 indicating to the most severe damage. Projection data were created based on BAM, and the SPECT reconstruction was performed. The ratio of the striatal to background region accumulation was set to a rate of 8:1, 6:1, and 4:1. The striatal and the reference VOI mean value were decreased as brain atrophy progressed. Additionally, the Bolt’s analysis methods revealed that the reference VOI value was more affected by brain atrophy than the striatal VOI value. Finally, the calculated SBR value was overestimated as brain atrophy progressed, and a similar trend was observed when the ratios of the striatal to background region accumulation were changed. This study thus suggests that the SBR can be overestimated in cases of advanced brain atrophy.

Who Could Be Blamed in the Case of Discrepant Histology and Serology Results for Helicobacter pylori Detection?

Background. Discrepancies between histology and serology results for Helicobacter pylori detection could be caused by a variety of factors, including a biopsy sampling error, expertise of the pathologist, natural loss of infection due to advanced atrophy, or a false-positive serology in the case of a previous infection, since antibodies may be present in blood following recovery from the infection. Aims. To identify true H. pylori-positive individuals in discrepant cases by serology and histology using real time polymerase chain reaction (RT-PCR) as a gold standard. Methods. Study subjects with discrepant histology and serology results were selected from the GISTAR pilot study data base in Latvia. Subjects having received previous H. pylori eradication therapy or reporting use of proton pump inhibitors, antibacterial medications, or bismuth containing drugs one month prior to upper endoscopy were excluded. We compared the discrepant cases to the corresponding results of RT-PCR performed on gastric biopsies. Results. In total, 97 individuals with discrepant results were identified: 81 subjects were serology-positive/histology-negative, while 16 were serology-negative/histology-positive. Among the serology-positive/histology-negative cases, 64/81 (79.0%) were false-positives by serology and, for the majority, inflammation was absent in all biopsies, while, in the serology-negative/histology-positive group, only 6.2% were proven false-positives by histology. Conclusions. Among this high H. pylori prevalent, middle-aged population, the majority of discrepant cases between serology and histology were due to false positive-serology, rather than false-negative histology. This confirms the available evidence that the choice of treatment should not be based solely on the serological results, but also after excluding previous, self-reported eradication therapy.

Endoscopic features and clinical importance of autoimmune gastritis.

Autoimmune gastritis (AIG) is a special type of chronic gastritis characterized by autoimmune disorders caused by cellular immunity, resulting in the destruction of parietal cells and production of antiparietal cell antibodies. Endoscopic findings of AIG are mainly characterized by corpus-dominant advanced atrophy. The antral area is generally considered to have no or mild atrophy; however, there are cases wherein the gastric mucosa is red or faded due to past infection with Helicobacter pylori or bile reflux. Currently, there are no diagnostic criteria for AIG in Japan, and it is important to make a diagnosis based on the presence of gastric autoantibodies and characteristic endoscopic and histological findings. AIG is associated with gastric cancer, neuroendocrine tumors (NETs), and other autoimmune diseases, such as thyroid diseases, anemia, and neurological symptoms due to impaired absorption of iron and vitamin B12 , and thus requires systemic treatment. The significance of diagnosing AIG is to include patients as a high-risk group for the development of gastric cancer and gastric NETs, provide an opportunity to detect autoimmune endocrine diseases, and initiate therapeutic intervention before anemia and neurological symptoms develop. It is important to pay close attention to the occurrence of AIG comorbidities not only at the time of AIG diagnosis but also during follow-up after detection.

Brain atrophy and endovascular treatment effect in acute ischemic stroke: a secondary analysis of the MR CLEAN trial.

BackgroundBrain atrophy is suggested to impair the potential for functional recovery after acute ischemic stroke. We assessed whether the effect of endovascular treatment is modified by brain atrophy in patients with acute ischemic stroke due to large vessel occlusion.MethodsWe used data from MR CLEAN, a multicenter trial including patients with acute ischemic stroke due to anterior circulation large vessel occlusion randomized to endovascular treatment plus medical care (intervention) versus medical care alone (control). We segmented total brain volume (TBV) and intracranial volume (ICV) on baseline non-contrast computed tomography (n = 410). Next, we determined the degree of atrophy as the proportion of brain volume in relation to head size (1 − TBV/ICV) × 100%, analyzed as continuous variable and in tertiles. The primary outcome was a shift towards better functional outcome on the modified Rankin Scale expressed as adjusted common odds ratio. Treatment effect modification was tested using an interaction term between brain atrophy (as continuous variable) and treatment allocation.ResultsWe found that brain atrophy significantly modified the effect of endovascular treatment on functional outcome (P for interaction = 0.04). Endovascular treatment led to larger shifts towards better functional outcome in the higher compared to the lower range of atrophy (adjusted common odds ratio, 1.86 [95% CI: 0.97–3.56] in the lowest tertile vs. 1.97 [95% CI: 1.03–3.74] in the middle tertile vs. 3.15 [95% CI: 1.59–6.24] in the highest tertile).ConclusionBenefit of endovascular treatment is larger in the higher compared to the lower range of atrophy, demonstrating that advanced atrophy should not be used as an argument to withhold endovascular treatment.

Examination of the stresses of the implants applied to the atrophic edentulous maxilla on the maxillary bone

Aim: In advanced atrophy of the posterior maxilla, applied zygoma implants increase the success of the surgical procedure by reducing morbidity and procedure time. In our study, using tomographic records, a model with posterior atrophy was obtained in a computer environment, and zygomatic and dental implants in different numbers and localizations were applied to this model. The aim of our study was to choose the most accurate surgical planning according to the stresses arising from the applied forces.
 Methodology: In our study, one zygoma implant on the right and left in Group 1, two zygoma implants in Group 2, one zygoma implant in Group 3 and one dental implant in the first premolar tooth area, one zygoma implant in Group 4 and one dental implant in the lateral tooth area and one zygoma implant in Group 5 and one dental implant in the lateral and a first premolar tooth area were applied. 150 N were applied vertically to the prosthetic superstructure from the lateral tooth, 1st premolar tooth, 1st molar tooth and 2nd molar tooth. As a result of the applied forces, the maximum stress values ​​in the maxilla molar region were examined by finite element stress analysis.
 Results: In our study, it was observed that Group 1 had the highest stress value, followed by Group 3. Stress values in Groups 2, 4 and 5 were low and they were measured close to each other.
 Conclusion: As a result of our study, it was seen that zygomatic and dental implants applied in addition to the zygomatic implant reduce stress and the localization of dental implants affect the stress values.
 
 How to cite this article: Gülsün B, Çetindağ A. Examination of the stresses of the implants applied to the atrophic edentulous maxilla on the maxillary bone. Int Dent Res 2021;11(Suppl.1):210-5. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.30
 
 
 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Бронхіальна астма як патофізіологічний чинник формування саркопенії

Актуальність. В умовах бронхіальної обструкції при бронхіальній астмі (БА) розвиваються зміни газового складу крові, оксидативний стрес, електролітний і метаболічний дисбаланси, що сприяють формуванню емфіземи легень і хронічної дихальної недостатності. При цьому виникають зміни дихальних м’язів, зокрема й у діафрагмі, що характеризуються прогресуючою їх атрофією з наступною втратою м’язової сили й маси. Мета: визначення функціональних можливостей скелетних м’язів і частоти розвитку саркопенії у хворих на БА. Матеріали та методи. Обстежено 70 осіб віком 47,82 ± 13,54 року. Першу групу становили 35 пацієнтів, які хворіють на БА, другу — 35 здорових осіб. Для оцінки функціональних можливостей скелетних м’язів застосовували 8-кроковий тест визначення швидкості ходьби. Силу скелетної мускулатури оцінювали за допомогою ручного пружинного динамометра. За величиною окружності гомілки оцінювали стан м’язової маси, якість життя вивчали за допомогою опитувальника О.С. Чабана. Результати. При оцінці сили скелетної мускулатури встановлено зменшення показників кистьової динамометрії на 22 % при тяжкому перебігу БА порівняно з показниками хворих на БА середньої тяжкості і на 29 % — порівняно із показниками здорових осіб. Встановлено кореляційні зворотні зв’язки між тяжкістю БА та силою кисті в жінок (r = –0,65) і чоловіків (r = –0,3); швидкістю ходьби у жінок (r = –0,72) та чоловіків (r = –0,6); окружністю гомілки у жінок (r = –0,17) і чоловіків (r = –0,28). Зниження сили м’язів і толерантності до фізичного навантаження асоціювалось із втратою м’язового компонента в 80 % пацієнтів з БА. Висновки. Саркопенія діагностована у 5,71 % осіб контрольної групи і у 25,71 % хворих на БА. Залежно від тяжкості БА і віку хворих саркопенію виявлено у 9,5 % пацієнтів із середньотяжкою БА і у 35,71 % — із тяжкою БА; у 10,53 % осіб віком молодших 45 років і у 31,25 % — старших 45 років.

A comparative study of patients satisfaction with conventional and relined mandibular complete dentures

Edentulous patients are usually satisfied with the service of a conventional maxillary denture but not the mandibular denture, particularly if the patients present with advanced atrophy of residual ridges, systemic diseases, chronic tissue soreness or maladaptive denture wearing experience. For such patients, the relining of hard heat cured mandibular dentures with long term resilient denture liners may be considered as a non-surgical alternative to pre-prosthetic procedures or implant supported prostheses. Purpose of The Study: The purpose of the study was to compare the satisfaction level of the patients provided with both conventional and relined mandibular dentures. Materials and Methods: The study was conducted on fifteen edentulous patients. Each patient was provided with one maxillary and two mandibular complete dentures i.e. one conventional and another relined with long term silicone-based resilient liner (Molloplast-B). Patients’ general satisfaction with the two mandibular dentures was evaluated using questionnaire. The data so collected was compared and analyzed statistically. Results: The overall analysis of the results obtained from the study suggested that the use of soft liners may promote a more satisfying life for edentulous patients. There was an improvement in patients’ general satisfaction rating, ability to chew &speak, fit and comfort with relined mandibular dentures as compared to conventional acrylic resin mandibular dentures opposed by conventional maxillary dentures and the majority of patients had a preference for the relined mandibular dentures.

Bioactive Nanofiber-Based Conduits in a Peripheral Nerve Gap Management-An Animal Model Study.

The aim was to examine the efficiency of a scaffold made of poly (L-lactic acid)-co-poly(ϵ-caprolactone), collagen (COL), polyaniline (PANI), and enriched with adipose-derived stem cells (ASCs) as a nerve conduit in a rat model. P(LLA-CL)-COL-PANI scaffold was optimized and electrospun into a tubular-shaped structure. Adipose tissue from 10 Lewis rats was harvested for ASCs culture. A total of 28 inbred male Lewis rats underwent sciatic nerve transection and excision of a 10 mm nerve trunk fragment. In Group A, the nerve gap remained untouched; in Group B, an excised trunk was used as an autograft; in Group C, nerve stumps were secured with P(LLA-CL)-COL-PANI conduit; in Group D, P(LLA-CL)-COL-PANI conduit was enriched with ASCs. After 6 months of observation, rats were sacrificed. Gastrocnemius muscles and sciatic nerves were harvested for weight, histology analysis, and nerve fiber count analyses. Group A showed advanced atrophy of the muscle, and each intervention (B, C, D) prevented muscle mass decrease (p < 0.0001); however, ASCs addition decreased efficiency vs. autograft (p < 0.05). Nerve fiber count revealed a superior effect in the nerve fiber density observed in the groups with the use of conduit (D vs. B p < 0.0001, C vs. B p < 0.001). P(LLA-CL)-COL-PANI conduits with ASCs showed promising results in managing nerve gap by decreasing muscle atrophy.

STUDY OF THE KNOWLEDGE AND USE OF RESILIENT DENTURE LINING MATERIALS IN CLINICAL PRACTICE

Introduction: Since the beginning of the last century until today, resilient resins have been used for the lining of partial and complete dentures with the aim to achieve more uniform distribution of masticatory pressure and to reduce the trauma of mucous membranes. The aim of this study was to investigate the knowledge and use of resilient denture lining materials (RDLMs) in clinical practice. Material and methods: The study was conducted among dental practitioners and dental technicians in 2016. A direct survey method was used, with a questionnaire containing 11 questions. Results: Over half (53.4%, n = 133) of the respondents do not use RDLMs in their practice. In the cases of retentive prosthetic field or prosthetic field with advanced atrophy, the respondents focus mainly on the surgical preparation of the prosthetic field and recommend the use of RDLMsif there are exostosis-related pain symptoms (≈41%, n = 103) or painful neurogenic points (≈ 44%, n = 105). One-third of the respondents prefer the use of long-term RDLMs, and 73% prefer to apply the indirect lining technique. Conclusion: The various types of RDLMs and their characteristics are well-known by the dental practitioners and dental technicians but rarely used, due to a number of unresolved related issues, such as ungluing of the resilient material from the denture base, appearance of an unpleasant odor, change in the color or texture of the material, etc. In our study, dental practitioners and dental technicians use RDLMsfor complete denture lining mainly in clinical cases with presented pain symptoms.

Changes of 18 F-fluoro-2-deoxyglucose position-emission tomography findings by the eradication of Helicobacter pylori in the stomach.

Helicobacter pylori (HP) infection is reported to increase 18 F-fluoro-2-deoxyglucose (FDG) accumulation in the stomach. The accumulation of FDG by positron-emission tomography (FDG-PET) in the stomach for the voluntary health examinees of cancer checkup was examined before and after the HP eradication. From March 2013 to October 2015, eighty-one subjects were performed FDG-PET to detect cancer at the health checkup. All of them were also surveyed by esophagogastroduodenoscopy. Subjects were classified as the 33 cases of HP positive (group A), 38 cases of originally negative (group B), and the 10 negative cases by HP eradication therapy (group C). Group A was treated by combination of amoxicillin, clarithromycin, and proton pump inhibitor for a week, and all of them eradicated HP. A part of group A (n=7) was serially performed FDG-PET one to five years after the treatment and compared the maximum standard uptake value of FDG (SUV) around the fundic gland region. SUV of group A (3.55±0.69) was significantly higher than those of both group B (2.96±0.72) and group C (2.89±0.51) (p<0.01, respectively). Groups B and C are almost comparable and showed no significant difference during the course. In group A, HP eradication significantly decreased the SUV to 3.1±0.43 (P<.01). SUV after the eradication was significantly reduced (P<.01) in the mild to moderate atrophy (C1-C3) group according to Kimura and Takemoto classification of chronic gastritis of group A. Although SUV in the advanced atrophy group (O1-O3) tended to decline after the eradication, the change was not significant. HP-infected stomach showed higher FDG uptake in the fundic gland region and HP eradication decreased the uptake in the mild to moderate atrophic gastritis but not in the severe atrophic gastritis.

A Comparison of Outcomes After Endoscopic Repair of Partial- Versus Full-Thickness Tears of the Gluteus Medius Tendon

The purpose of this study was to evaluate and compare the functional outcomes after endoscopic repair of partial or full-thickness gluteus medius tears at a minimum 2 years' follow-up. Patients with isolated tears ofthe gluteus medius tendon repaired endoscopically between 2012 and 2017 were evaluated at a minimum 2 years of follow-up. Patients with large, retracted and/or irreducible tears, advanced atrophy, or fatty degeneration or with concomitant other hip pathology were excluded. Functional outcomes were assessed using the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and visual analog scale (VAS) for pain preoperatively and at the last follow-up RESULTS: Forty-six patients, 3 men and 43 women with a mean (SD) age of 63 (9; range, 43-82) years, were included. Thirty-three patients (72%) had partial-thickness tears and 13 (28%) had full-thickness tears. Pain was reduced significantly from a median of 8 (IQR: 6-8) at the preoperative visit to a median of 2 (IQR: 15) at the most recent follow-up (P<.0001). The mHHS and NAHS improved significantly from a median of 44 (IQR: 35-52) to 80 (IQR: 64-87) (P<.0001) and 52 (IQR: 43-56) to 75 (IQR: 66-94) (P < .0001), respectively. These improvements were clinically relevant and surpass the reported minimal clinically important difference. Patients with partial tears had significant functional gains in the mHHS in comparison with patients with full-thickness tears (P= .02). No other statistically significant difference between groups of tear grade was observed. Endoscopic repair of gluteus medius tendon tears yields excellent functional outcomes at a minimum follow-up of 2 years. A lower functional improvement for full-thickness tears was observed; this difference was statistically significant for 1 of the 2 scores evaluated. Level III, retrospective comparative cohort.