Lesions In Participants Research Articles

The Effect of Severe Coronary Calcification on Diagnostic Performance of Computed Tomography-Derived Fractional Flow Reserve Analyses in People with Coronary Artery Disease.

Negative CCTA can effectively exclude significant CAD, eliminating the need for further noninvasive or invasive testing. However, in the presence of severe CAD, the accuracy declines, thus necessitating additional testing. The aim of our study was to evaluate the diagnostic performance of noninvasive cFFR derived from CCTA, compared to ICA in detecting hemodynamically significant stenoses in participants with high CAC scores (>400). This study included 37 participants suspected of having CAD who underwent CCTA and ICA. CAC was calculated and cFFR analyses were performed using an on-site machine learning-based algorithm. Diagnostic accuracy parameters of CCTA and cFFR were calculated on a per-vessel level. The median total CAC score was 870, with an IQR of 642-1370. Regarding CCTA, sensitivity and specificity for RCA were 60% and 67% with an AUC of 0.639; a LAD of 87% and 50% with an AUC of 0.688; an LCX of 33% and 90% with an AUC of 0.617, respectively. Regarding cFFR, sensitivity and specificity for RCA were 60% and 61% with an AUC of 0.606; a LAD of 75% and 54% with an AUC of 0.647; an LCX of 50% and 77% with an AUC of 0.647. No significant differences between AUCs of coronary CTA and cFFR for each vessel were found. Our results showed poor diagnostic accuracy of CCTA and cFFR in determining significant ischemia-related lesions in participants with high CAC scores when compared to ICA. Based on our results and study limitations we cannot exclude cFFR as a method for determining significant stenoses in people with high CAC. A key issue is accurate and detailed lumen segmentation based on good-quality CCTA images.

Association between glycemia and multi-vessel lesion in participants undergoing coronary angiography: a cross-sectional study.

This study aims to elucidate the association between glycemia and the occurrence of multi-vessel lesions in participants undergoing coronary angiography. We analyzed 2,533 patients with coronary artery disease who underwent coronary angiography. Of these, 1,973 patients, identified by the endpoint of multi-vessel lesions, were examined using univariate and multivariate logistic regression analyses to determine the relationship between glycemia levels and multi-vessel lesion occurrence. The analysis included 1,973 participants, among whom 474 patients were identified with coronary multi-vessel lesions. Univariate logistic regression analysis demonstrated a positive correlation between glycemia and the occurrence of coronary multi-vessel lesions (OR 1.04; 95% CI 1.01-1.08; p = 0.02). The adjusted model indicated that for each unit increase in glycemia, the risk of developing coronary multi-vessel lesions increased by 4%, showing a significant correlation (p < 0.05). Subgroup analyses revealed that the impact of glycemia on multi-vessel lesions in patients with PCI varied according to gender, age, and smoking status, with the effect being more pronounced in men, older patients, and smokers. Our findings establish a significant association between glycemia and the incidence of multi-vessel lesions, particularly pronounced in male patients, individuals over 45, and smokers.

Evaluation of the Effects of Punica granatum Flower Tablets on Pain and Healing of Minor Recurrent Aphthous Stomatitis: A Randomized Clinical Trial.

The purpose of this study was to determine the therapeutic effect of the Punica granatum (PG) flower on recurrent aphthous stomatitis in comparison with corticosteroid therapy. This cross-over randomized clinical trial was conductedon the patients who had been referred to Shiraz Dental School for their RAS in 2021. All the participants used both P. granatum flower tablets and Triadent a month apart for wash-out time and all compared themselves. In the experimental group, 30 patients received pomegranate flower tablets, three tablets daily, for 6 days. In the control group, oral paste Triadent has been prescribed three times a day for 6 days. The visual analog scale (VAS) and the size of RAS were evaluated on Days 0-6. Data were analyzed by SPSS version 21. The Wilcoxon test was used. The mean age of participants was 27.8 ± 14.77 years old. In this study, 15 patients (50%) were men and 15 patients (50%) were women. The mean value of VAS after using prescribed treatment in both evaluated groups on all days was significantly different such that the VAS values were lower for PG flower tablets than Triadent (p value < 0.05). The size of oral lesions in participants who used PG flower tablets was significantly less than those who used Triadent on all evaluation days (p value < 0.05) except on Day 1 (p value = 0.29). The descending slope of VAS from Days 1 to 6 for both Triadent and PG flower tablet users was significant and noticeable. (p value < 0.05). According to the result of this study, both P. granatum flower tablet and Triadent are useful in reducing the size, period of healing, and VAS of patients with RAS, but the PG flower tablet is more effective.

Neuroimaging Findings in US Government Personnel and Their Family Members Involved in Anomalous Health Incidents

US government personnel stationed internationally have reported anomalous health incidents (AHIs), with some individuals experiencing persistent debilitating symptoms. To assess the potential presence of magnetic resonance imaging (MRI)-detectable brain lesions in participants with AHIs, with respect to a well-matched control group. This exploratory study was conducted at the National Institutes of Health (NIH) Clinical Center and the NIH MRI Research Facility between June 2018 and November 2022. Eighty-one participants with AHIs and 48 age- and sex-matched control participants, 29 of whom had similar employment as the AHI group, were assessed with clinical, volumetric, and functional MRI. A high-quality diffusion MRI scan and a second volumetric scan were also acquired during a different session. The structural MRI acquisition protocol was optimized to achieve high reproducibility. Forty-nine participants with AHIs had at least 1 additional imaging session approximately 6 to 12 months from the first visit. AHIs. Group-level quantitative metrics obtained from multiple modalities: (1) volumetric measurement, voxel-wise and region of interest (ROI)-wise; (2) diffusion MRI-derived metrics, voxel-wise and ROI-wise; and (3) ROI-wise within-network resting-state functional connectivity using functional MRI. Exploratory data analyses used both standard, nonparametric tests and bayesian multilevel modeling. Among the 81 participants with AHIs, the mean (SD) age was 42 (9) years and 49% were female; among the 48 control participants, the mean (SD) age was 43 (11) years and 42% were female. Imaging scans were performed as early as 14 days after experiencing AHIs with a median delay period of 80 (IQR, 36-544) days. After adjustment for multiple comparisons, no significant differences between participants with AHIs and control participants were found for any MRI modality. At an unadjusted threshold (P < .05), compared with control participants, participants with AHIs had lower intranetwork connectivity in the salience networks, a larger corpus callosum, and diffusion MRI differences in the corpus callosum, superior longitudinal fasciculus, cingulum, inferior cerebellar peduncle, and amygdala. The structural MRI measurements were highly reproducible (median coefficient of variation <1% across all global volumetric ROIs and <1.5% for all white matter ROIs for diffusion metrics). Even individuals with large differences from control participants exhibited stable longitudinal results (typically, <±1% across visits), suggesting the absence of evolving lesions. The relationships between the imaging and clinical variables were weak (median Spearman ρ = 0.10). The study did not replicate the results of a previously published investigation of AHIs. In this exploratory neuroimaging study, there were no significant differences in imaging measures of brain structure or function between individuals reporting AHIs and matched control participants after adjustment for multiple comparisons.

316-OR: ADA Presidents' Select Abstract: Structural Lesions on Kidney Biopsy in Youth-Onset Type 1 Diabetes (T1D) and Type 2 Diabetes (T2D)

Recent epidemiological studies suggest a more aggressive clinical course of diabetic kidney disease in youth-onset T2D compared with youth-onset T1D. We compared kidney structural lesions in participants with youth-onset T2D and T1D to determine if youth-onset T2D was associated with greater early tissue injury. Quantitative microscopy was performed on kidney tissue obtained from research kidney biopsies in 27 youth with diabetes (13 T2D, 14 T1D). Group differences in clinical and morphometric parameters were tested using t-tests, Wilcoxon signed-rank test and linear models. At biopsy, the 13 participants with T2D were younger than the 14 with T1D (17±2 vs. 23±2 years; p&amp;lt;0.0001), had shorter diabetes duration (2.4±1.9 vs. 12.3±5.2 years; p&amp;lt;0.0001), but similar HbA1c (6.6±1.0 vs. 7.3±1.0 %; p=0.10) and median urine albumin-to-creatinine ratio (6 [min-max: 1-163] vs. 7 [2-58] mg/g; p=0.96). Youth with T2D exhibited greater glomerular tuft area (17588±4806 vs. 13821±2748 um2, p=0.018), glomerular volume (3.4±1.4 vs. 2.31±0.68 106um3, p=0.018), glomerular nuclear count (101±23 vs. 63±11, p&amp;lt;0.0001) mesangial volume (0.44±0.15 vs. 0.28±0.09 106um3, p=0.002) and mesangial matrix (2291±531 vs. 2001±566 um2, p=0.008). Glomerular sclerosis was only present in one individual with T2D. Despite similar clinical characteristics and considerably shorter diabetes duration, youth with T2D exhibited more severe kidney structural lesions than young persons with youth-onset T1D. Studies are underway to elucidate the metabolic and molecular pathways underlying these structural differences, as well as to delineate potential ultrastructural differences in T2D vs. T1D by electron microscopy. Disclosure V.Nair: None. V.Shah: Advisory Panel; LifeScan Diabetes Institute, Medscape, Consultant; DKSH, Research Support; Novo Nordisk, Tandem Diabetes Care, Inc., Dexcom, Inc., Insulet Corporation, JDRF, National Institutes of Health, Speaker's Bureau; Dexcom, Inc., Insulet Corporation. K.L.Tommerdahl: None. K.Sharma: Advisory Panel; Reata Pharmaceuticals, Inc., Otsuka America Pharmaceutical, Inc. I.De boer: Advisory Panel; AstraZeneca, Boehringer Ingelheim and Eli Lilly Alliance, Boehringer Ingelheim International GmbH, Otsuka America Pharmaceutical, Inc., Bayer Inc., Consultant; George Clinical, Gilead Sciences, Inc., Medscape, Research Support; Dexcom, Inc. P.Saulnier: Board Member; Novo Nordisk, Consultant; Grünenthal Group. H.C.Looker: None. R.G.Nelson: None. J.B.Hodgin: None. P.Bjornstad: Advisory Panel; AstraZeneca, Novo Nordisk, Lilly, Horizon Therapeutics plc, Boehringer Ingelheim (Canada) Ltd., LG Chem, Consultant; Bayer Inc., Bristol-Myers Squibb Company. A.Naik: Advisory Panel; CareDx. F.Alakwaa: None. J.A.Schaub: None. T.B.Vigers: None. M.Bitzer: None. L.Pyle: None. F.C.Brosius: Advisory Panel; Gilead Sciences, Inc. P.E.Ladd: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases; JDRF

Safety and Clinical Efficacy Outcomes From the Long-term Extension Study of Tolebrutinib in Participants With Relapsing Multiple Sclerosis: 2.5-Year Results (S16.010)

Safety and Clinical Efficacy Outcomes From the Long-term Extension Study of Tolebrutinib in Participants With Relapsing Multiple Sclerosis: 2.5-Year Results (S16.010)

Myelin Water Fraction of Slowly Evolving Lesions is Associated With Disability in Multiple Sclerosis (P10-3.017)

Myelin Water Fraction of Slowly Evolving Lesions is Associated With Disability in Multiple Sclerosis (P10-3.017)

MRI lesions in SpA: a comparison with noninflammatory back pain using propensity score adjustment method.

Background:Magnetic resonance imaging (MRI) is important in the management of axial spondyloarthritis (SpA). However, many MRI lesions are not exclusive to axial SpA. Further characterization of these lesions may lead to better clinical decisions.Objective:The objective of this study was to compare the frequency of individual spinal MRI lesions between axial SpA and noninflammatory back pain. The factors associated with individual lesions in participants with axial SpA were also determined.Design:This was a cross-sectional observational study.Methods:MRI lesions in 447 participants with axial SpA and 122 participants with noninflammatory back pain were compared using the propensity score adjustment method. Individual lesions included discovertebral lesions (DVL), Modic type 1 lesions, DVL without Modic type 1 lesions, facet joint lesions, costovertebral joint lesions, corner inflammatory lesions (CIL), and fatty corner lesions (FCL). The factors associated with the lesions were determined using regression analyses.Results:Among participants with axial SpA, 81.9% were HLA-B27-positive, 55.0% had radiographic axial SpA, and 60.5% had radiographic features of spinal damage (mSASSS >2). Almost half (48.6% in axial SpA versus 31.1% in noninflammatory back pain) had inflammatory lesions on spinal MRI. In propensity score matching with noninflammatory back pain, axial SpA had an increased occurrence of DVL without Modic type 1 lesion (OR = 3.43, p = 0.01), costovertebral lesion (OR = 11.89, p = 0.02), number of CIL (B = 1.19, p < 0.001), and number of FCL (B = 3.33, p < 0.001). Similar associations were found in the regression models in the radiographic axial SpA subgroup: DVL without Modic type 1 lesion (OR = 2.46, p = 0.001), costovertebral lesion (OR = 3.86, p < 0.001), number of CIL (B = 1.13, p < 0.001), and FCL (B = 2.29, p < 0.01).Conclusion:MRI lesions including DVL without Modic type 1, costovertebral joint lesions, CIL, and FCL were more specific in axial SpA.

Propanediol (and) Caprylic Acid (and) Xylitol as a New Single Topical Active Ingredient against Acne: In Vitro and In Vivo Efficacy Assays.

In addition to dermatological complications, acne can affect the quality of life of individuals in numerous ways, such as employment, social habits and body dissatisfaction. According to our expertise, caprylic acid and propanediol would not have a direct action on Cutibacterium acnes. Despite this, we investigated the existence of a synergistic effect among xylitol, caprylic acid and propanediol as a mixture of compounds representing a single topical active ingredient that could benefit the treatment against acne. In vitro and in vivo assays were performed to challenge and to prove the efficacy of propanediol, xylitol and caprylic acid (PXCA) against acne. PXCA had its MIC challenged against C. acnes (formerly Propionibacterium acnes) and Staphylococcus aureus, resulting in concentrations of 0.125% and 0.25%, respectively, and it also developed antimicrobial activity against C. acnes (time-kill test). PXCA was able to reduce the 5-alpha reductase expression in 24% (p < 0.01) in comparison with the testosterone group. By the end of 28 days of treatment, the compound reduced the skin oiliness, porphyrin amount and the quantity of inflammatory lesions in participants. According to the dermatologist evaluation, PXCA improved the skin’s general appearance, acne presence and size.

VYTR hypothesis for the prophylactic and therapeutic efficacy of GS-5734 treatment in humans with COVID-19

In December 2019, many pneumonia cases were reported without an apparent cause but were associated with seafood and wet markets in Wuhan, China Clinical features were similar to pneumonia, and severe acute respiratory syndrome (SARS-CoV-2) (formerly 2019-nCoV) was determined as the causative pathogen. To date, there are no effective antiviral drugs for the targeted treatment of coronavirus disease 2019 (COVID-19). We provide the VITYALA YETHINDRA (VYTR) hypothesis for the prophylactic and therapeutic efficacy of GS-5734 treatment in humans with COVID-19. Prophylactic GS-5734 treatment may prevent SARS-CoV-2 induced disease and lung lesions in participants inoculated with SARS-CoV-2 and potentially inhibit SARS-CoV-2 replication. Therapeutic GS-5734 treatment may show a reduction in the severity of symptoms, reduce viral replication, the absence of lung lesions in some participants and decrease in lesions in 50% of participants may be possible. As broad-spectrum drugs are capable of inhibiting coronavirus infections, GS-5734 should be considered a broad-spectrum, first-line drug and may inhibit coronavirus infections and COVID-19. More clinical trials are needed to prove that GS-5734 (Remdesivir) is a safe and effective drug for the treatment of COVID-19.

Spatial distribution of early red lesions is a risk factor for development of vision-threatening diabetic retinopathy

Aims/hypothesisDiabetic retinopathy is characterised by morphological lesions related to disturbances in retinal blood flow. It has previously been shown that the early development of retinal lesions temporal to the fovea may predict the development of treatment-requiring diabetic maculopathy. The aim of this study was to map accurately the area where lesions could predict progression to vision-threatening retinopathy.MethodsThe predictive value of the location of the earliest red lesions representing haemorrhages and/or microaneurysms was studied by comparing their occurrence in a group of individuals later developing vision-threatening diabetic retinopathy with that in a group matched with respect to diabetes type, age, sex and age of onset of diabetes mellitus who did not develop vision-threatening diabetic retinopathy during a similar observation period.ResultsThe probability of progression to vision-threatening diabetic retinopathy was higher in a circular area temporal to the fovea, and the occurrence of the first lesions in this area was predictive of the development of vision-threatening diabetic retinopathy. The calculated peak value showed that the risk of progression was 39.5% higher than the average. There was no significant difference in the early distribution of lesions in participants later developing diabetic maculopathy or proliferative diabetic retinopathy.Conclusions/interpretationThe location of early red lesions in diabetic retinopathy is predictive of whether or not individuals will later develop vision-threatening diabetic retinopathy. This evidence should be incorporated into risk models used to recommend control intervals in screening programmes for diabetic retinopathy.

Multi-Domain Assessment of Autonomic Function in Spinal Cord Injury Using a Modified Autonomic Reflex Screen.

The aim of this study was to characterize autonomic lesions in participants with spinal cord injury (SCI; n = 10) using an autonomic reflex screen, incorporating sudomotor, cardiovagal, and sympathetic adrenergic tests, as well as hemodynamic responses to head-up tilt (HUT). Hemodynamic responses were compared to healthy controls (n = 20) and previously published normative cutoffs in order better identify autonomic impairments. Sympathetic skin responses (SSRs), heart rate response to deep breathing (HRDB), and heart rate and beat-to-beat blood pressure responses to Valsalva maneuver (VM) and HUT were measured. SCI participants demonstrated impairment in at least one domain, with 7 of 10 demonstrating autonomic impairment across all domains. No single test was concordant with orthostatic hypotension on HUT, in all participants. Measures of cardiovagal function, including HRDB (SCI = 7.7 ± 3.8 beats/min vs. controls = 17.6 ± 8.1 beats/min) and Valsalva ratio (SCI = 1.53 ± 0.29 vs. controls = 1.85 ± 0.37), were significantly reduced in SCI participants, compared to controls (p < 0.05). These findings suggest that an autonomic reflex screen, which includes standardized testing protocol and normative data for comparison, is useful for determining the autonomic domains affected by the neurological injury in SCI. We also demonstrated significant cardiovagal impairment in SCI participants compared to controls, which warrants further investigation to determine whether cardiovagal dysfunction is associated with the negative cardiovascular outcomes, which are known to occur in SCI.

Effect of the use of silver nanocrystals and silver sulfadiazine in the management of soft tissue lesions

Effect of the use of silver nanocrystals and silver sulfadiazine in the management of soft tissue lesions Cristian Tineo,1 Cinthia M Nuñez,2–4 Ouel Sosa,1,5 Dahiana Pichardo,1 Juan Luis Hernández,1 Gustavo Collado3 1Department of Surgery, José María Cabral y Báez Regional and University Hospital (HRUJMCB), 2Department of Surgery, Dr. Arturo Grullòn University and Childrens Hospital Burn Unit (HIRUDAG), 3Department of Surgery, Santiago Metropolitan Hospital (HOMS), 4Department of Medicine, Mother and Master Pontifical and Catholic University (PUCMM), 5Department of Medicine, Santiago Thechnological University (UTESA), Santiago, Dominican Republic Background: Soft tissue lesions represent a health problem of great magnitude around the world. Multiple drugs have been used in their treatment. Silver sulfadiazine (SSD) and silver nanocrystals (SNC) are among the most used. The purpose of this research was to compare the effectiveness of SSD and SNC regarding the wound granulation rate, treatment time, antibiotic effect, and treatment cost and to determine the frequency of these lesions in participants of this research.Methods: Data were collected from 50 patients with soft tissue lesions in the Regional University Hospital José María Cabral y Báez (HRUJMCB), in Santiago, Dominican Republic. This study was approved by the bioethics committee of the Pontifical Catholic University Madre and Maestra (PUCMM) and the HRUJMCB. Patients were followed up from August 2015 to February 2016. SPSS Statistics program was used to calculate Chi square and assess statistical significance.Results: Fifty patients were included in this study, of whom 56% had diabetic foot ulcers, 22% had vascular ulcers, and 22% had pressure ulcers. In total, 42% of the patients were treated with SSD and 58% with SNC. Granulation rate was 71.4% for SSD and 89.6% for SNC, and positive antibiotic effect was 15.9% for SSD and 25.9% for SNC. A total of 14.4% of patients treated with SSD ended their participation in the research between 8 and 14 days, 37.9% in 15–21 days, and 42.8% in ≥21 days. For SNC, 3.4% of patients concluded their participation in 0–7 days, 34.4% in 8–14 days, 37.9% in 15–21 days, and 24.1% in ≥21 days. The distribution of economic costs in the SSD group was as follows: USD0–22, 42.9%, and USD22–66, 57.2%, while in the SNC group, the distribution was as follows: USD0–22, 48.2%; USD22–66, 48.3%; and USD66–110, 3.4%.Conclusion: There is no statistical significance in the results of this study; however, in percentage, SNC are superior regarding the rate of wound granulation, antibiotic effect, and healing time. Economic cost for both is similar. Keywords: silver, sulfadiazine, nanocrystals, ulcers

Clinical patterns of dystonia and choreoathetosis in participants with dyskinetic cerebral palsy.

The aim of the study was to map clinical patterns of dystonia and choreoathetosis and to assess the relation between functional classifications and basal ganglia and thalamus lesions in participants with dyskinetic cerebral palsy (CP). In this cross-sectional study, 55 participants with dyskinetic CP (mean age 14y 6mo, SD 4y 1mo; range 6-22y) were assessed with the Dyskinesia Impairment Scale and classified with the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS). Dystonia and choreoathetosis are simultaneously present. Median levels of dystonia (70.2%) were significantly higher than levels of choreoathetosis (26.7%) and both were significantly higher during activity than at rest (both p<0.01). High correlations were found between dystonia levels and GMFCS level (Spearman's rank correlation coefficient, rS =0.70; 95% confidence interval [CI] 0.53-0.81; p<0.01) and MACS (rS =0.65; 95% CI 0.47-0.81; p<0.01), and fair correlation with CFCS (rs =0.36; 95% CI=0.11-0.57; p<0.05). No significant correlation was found between choreoathetosis levels and motor classifications. Finally, higher choreoathetosis levels were found in participants with pure thalamus and basal ganglia lesions (p=0.03) than mixed lesions, but not for dystonia (p=0.41). Dystonia and choreoathetosis increase during activity. However, dystonia predominates and seems to have a larger impact on functional abilities. Our findings further suggest that choreoathetosis seems to be more linked to pure thalamus and basal ganglia lesions than dystonia.

Alemtuzumab for the treatment of relapsing-remitting multiple sclerosis.

Alemtuzumab, a humanized monoclonal antibody that targets CD52, was recently approved in the EU and Canada for the treatment of patients with active relapsing-remitting multiple sclerosis. Alemtuzumab induces rapid depletion of circulating B- and T-lymphocytes followed by repopulation that leads to a distinctive lymphocyte profile, including an increased proportion of regulatory T-lymphocytes and memory B- and T-lymphocytes. In early open-label studies, alemtuzumab treatment reduced the number of clinical relapses and new MRI lesions in participants with secondary progressive MS. However, most participants had continued worsening of disability, which led to the evaluation of alemtuzumab in patients with early stages of disease in the Genzyme (MA, USA)-sponsored clinical development program in MS. In one PhaseII and two Phase III trials, alemtuzumab reduced the number of clinical relapses versus the active comparator, subcutaneous IFN-β-1a, in treatment-naive and treatment-experienced participants with relapsing-remitting multiple sclerosis. Two of these trials showed reduction in risk of confirmed worsening of disability, and all showed reduction in cerebral atrophy. Safety issues include infusion reactions that are mitigated by pretreatment with corticosteroids in addition to symptomatic management with antihistamines; mild to moderate infections; and autoimmune adverse events. In this context, post-marketing risk mitigation strategies will be needed so that potential adverse events can be identified and managed early and effectively.

Erosive Lesions in Patients With Alcoholism

The authors conducted a study to determine the occurrence of erosive tooth lesions in patients with alcoholism and to establish the influence of salivary flow rates and pH levels on their appearance. The authors conducted a cross-sectional study in 140 participants (70 with clinically diagnosed alcoholism who were undergoing therapy for their addiction were in the test group and 70 who did not consume alcohol were in the control group). The authors determined the participants' salivary statuses by measuring the flow rates and pH levels of both unstimulated and stimulated saliva. The authors found more erosive lesions in the test group (P < .01). They detected a higher number of erosive lesions in participants in the test group who had a pH range of 5 to 6 compared with a pH range of 6 to 7 (P = .01). They found a significant correlation between alcoholism and unstimulated salivary flow rate (P < .05). The salivary flow rate was similar in control and test groups. The prevalence of erosion in the test group was higher than that in the control group, which may be related to the decrease in salivary pH of both stimulated and unstimulated saliva in this group. The results of the study showed no connection between erosion prevalence and pH levels and stimulated salivary flow rates. Patients with alcoholism may be at risk of developing erosive lesions on their teeth owing to the low pH level of their oral environment and decreased saliva levels.