Oral Treatment Research Articles

Changes in the type 2 diabetes gut mycobiome associate with metformin treatment across populations.

This is the largest to-date multi-country cohort characterizing the human gut mycobiome, and the first to investigate potential perturbations in gut fungi from oral pharmaceutical treatment. We demonstrate the reproducible effects of metformin treatment on the human and murine gut mycobiome and highlight a need to consider metformin as a confounding factor in investigations between type 2 diabetes mellitus and the gut microbial ecosystem.

Analysis of the Molecular Structure of Hydroxychavicol, a Promising Oral Antibacterial

Abstract Objectives In order to better understand hydroxychavicol’s effectiveness as an oral antibacterial, its structural components were analyzed with respect to minimum inhibitory concentrations and minimum bactericidal concentrations against various oral bacteria. These structural components include the free hydroxy groups and allyl chain connected to hydroxychavicol’s benzene core. Methods Six structural analogs of hydroxychavicol were tested against a range of oral bacteria using minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) assays. MIC results were obtained using serial microdilution techniques in 96-well plates with resazurin dye as a colorimetric indicator. Aliquots within each MIC concentration range were then placed on appropriate agar medium and the minimum bactericidal concentration was determined as the lowest concentration with no observed colony growth. Key Findings A synergistic interaction was observed between the allyl chain and hydroxy groups on the benzene core of hydroxychavicol, which resulted in lower MICs against the tested oral bacteria. It was also found that a hydroxy group para to the allyl chain on the benzene ring resulted in more effective inhibition, with a MIC of <50 μg/mL against R. dentocariosa. Additionally, analytes possessing free hydroxy groups ortho to one another on the benzene ring resulted in MICs of 200-300 μg/mL or lower, whereas analytes with free hydroxy groups meta to one another on the benzene ring exhibited MICs of >1000 μg/mL. Conclusions This study helps elucidate the structural components responsible for hydroxychavicol’s effectiveness as an oral antibacterial. The findings herein help to understand the mechanism of hydroxychavicol’s antibacterial properties and will be helpful in the design and synthesis of more effective oral antibacterial treatments.

Local therapy in the postoperative management of patients with lower limb varicose vein disease

Introduction. Varicose veins of the lower extremities are one of the most common diseases, affecting 20 to 40% of the population. One of the most common treatment methods is endovenous laser coagulation (EVLC).Aim. To evaluate the effectiveness of local gel therapy based on escin, heparin and essential phospholipids in the postoperative administration of patients after endovenous laser coagulation.Materials and methods. A complex treatment of 53 patients with varicose veins of the lower extremities of classes C2-C3 according to the CEAP nomenclature was carried out. Patients were divided into 2 statically homogeneous groups with an equal number. All patients underwent endovenous laser obliteration of the trunk of the great saphenous vein in combination with miniphlebectomy of tributaries on the thigh and lower leg.Results. In both groups, the largest number were patients with incompetence of the GSV trunk up to the border in /3 and c/3 of the lower leg, with further discharge along the tributaries of the GSV along the medial surface of the lower leg. The failure of the GSV trunk to the level of the knee joint gap was accompanied by the presence of varicose-transformed tributaries along the anterior surface of the thigh, in the area of the knee joint. The addition of Detragel led to the relief of phlebitis and hematomas, a pronounced decrease in pain and edematous syndrome.Discussion. Transdermal drug delivery has great promise as an alternative to oral and intravenous treatment, especially for patients suffering from chronic diseases. The three-component composition allows you to influence all parts of the pathogenesis of the disease.Conclusion. The data obtained on the use of local gel therapy based on escin, heparin and essential phospholipids after EVLO of the GSV indicate the need for local therapy to improve the quality of life of patients, their rapid rehabilitation and improve immediate and long-term results.

WLB-87848, a Selective σ1 Receptor Agonist, with an Unusually Positioned NH Group as Positive Ionizable Moiety and Showing Neuroprotective Activity.

The synthesis and pharmacological activity of a new series of thieno[2,3-d]pyrimidin-4(3H)-one derivatives as sigma-1 receptor (σ1R) ligands are reported. A hit from a high-throughput screening program was evolved into a highly potent and selective σ1R agonist (14qR) that contains a free NH group as positive ionizable moiety, not fulfilling the usual pharmacophoric features of the σ1R. The compound shows good physicochemical and ADMET characteristics, displays an agonist profile in the binding immunoglobulin protein/σ1R association assay, induces neuron viability in an in vitro model of β-amyloid peptide intoxication, and presents positive results against recognition memory impairment induced by hippocampal injection of Aβ peptide in rats after oral treatment, altogether making 14qR (WLB-87848) an interesting candidate for neuroprotection.

Has Coca-Cola treatment become the first-line therapy for gastric bezoars, both in general and specifically for western countries?

Phytobezoars is a rare disease and less common in Western countries. The stomach is the primary site for these formations, and endoscopic treatment involving fragmentation and extraction has traditionally been the most effective approach. However, medical treatments using enzymatic and chemical agents, such as cellulase and Coca-Cola, aimed at dissolving the bezoars, have also been utilized, showing varying degrees of resolution success. Notably, the oral dissolution treatment with Coca-Cola has emerged as a promising, simpler, and more cost-effective method. The study by Liu et al represents an important step in clinical research on this topic, despite some limitations that need addressing for a more comprehensive understanding of its findings. Key considerations for future research include sample size calculation, endoscopic procedure details, outpatient vs. inpatient treatment, and detailed cost calculations. The study's exclusions, such as patients with upper gastric surgery, phytobezoars older than 14 d, and cases of gastroparesis, limit its applicability to broader populations, especially in Western countries. Given the promising outcomes of the Coca-Cola treatment, it's advocated as a first-line therapy for phytobezoars. Nonetheless, further research is essential to overcome these limitations. However special situations such as perforation or small bowel obstruction will require surgical treatment.

Intravesical oxybutynin treatment for neurogenic detrusor overactivity : Efficacy and safety data from clinical practice with the first intravesical oxybutynin treatment authorized in Germany

Existing therapies for neurogenic detrusor overactivity (NDO), i.e. oral anticholinergics and botulinum toxin injections, can be associated with serious adverse effects or are not always sufficiently effective. Therefore, there is aneed for alternative safe and effective treatment options for NDO. Intravesical oxybutynin has been successfully used for several years as a prescription drug in adults and children with spinal cord injury and spina bifida. In 2019, VESOXX® (FARCO-PHARMA, Cologne, Germany) became the first registered intravesical oxybutynin product in Germany, which is indicated for the suppression of neurogenic detrusor overactivity (NDO) in children from 6years of age and adults, who are managing bladder emptying by clean intermittent catheterisation (CIC), if they cannot be adequately managed by oral anticholinergic treatment due to lack of efficacy and/or intolerable side effects. Overall, there are limited data regarding therapy with intravesical oxybutynin, with the majority of publications being retrospective case series. To date, there are limited data on the efficacy and safety of the newly approved intravesical oxybutynin therapy (VESOXX®) in NDO patients. This noninterventional case series from daily routine treatment which evaluated the physician reports of 38patients suggests that intravesical oxybutynin effectively improves maximum detrusor pressure (Pdet max) by decreasing it by 59% from 51.94 cmH2O ± 26.12 standard deviation (SD) to 21.07 cmH2O ± 17.32 SD (P < 0.001, n = 34). Maximum bladder pressure (MBC) increased by 34% from 260.45 ml ± 200.26 SD to 348.45 ml ± 175.90 SD. Positive or similar effects compared to previous therapies were seen in bladder morphology, number of incontinence episodes, urinary tract infections and adverse drug effects. This case series demonstrates that intravesical oxybutynin is an important addition to current therapies for the treatment of NDO and it is also efficacious in the rare setting of other underlying diseases beyond spinal cord injury or spina bifida. The approved intravesical oxybutynin preparation VESOXX® may be auseful alternative for patients who do not respond to other therapies or suffered side effects.

Montelukast improves disease outcome in SOD1G93A female mice by counteracting oligodendrocyte dysfunction and aberrant glial reactivity.

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder characterized by progressive motor neuron (MN) loss and consequent muscle atrophy, for which no effective therapies are available. Recent findings reveal that disease progression is fuelled by early aberrant neuroinflammation and the loss of oligodendrocytes with neuroprotective and remyelinating properties. On this basis, pharmacological interventions capable of restoring a pro-regenerative local milieu and re-establish proper oligodendrocyte functions may be beneficial. Here, we evaluated the in vivo therapeutic effects of montelukast (MTK), an antagonist of the oligodendroglial G protein-coupled receptor 17 (GPR17) and of cysteinyl-leukotriene receptor 1 (CysLT1R) receptors on microglia and astrocytes, in the SOD1G93A ALS mouse model. We chronically treated SOD1G93A mice with MTK, starting from the early symptomatic disease stage. Disease progression was assessed by behavioural and immunohistochemical approaches. Oral MTK treatment significantly extended survival probability, delayed body weight loss and ameliorated motor functionalityonly in female SOD1G93A mice. Noteworthy, MTK significantly restored oligodendrocyte maturation and induced significant changes in the reactive phenotype and morphological features of microglia/macrophages and astrocytes in the spinal cord of female SOD1G93A mice, suggesting enhanced pro-regenerative functions. Importantly, concomitant MN preservation has been detected after MTK administration. No beneficial effects were observed in male mice, highlighting a sex-based difference in the protective activity of MTK. Our results provide the first preclinical evidence indicating that repurposing of MTK, a safe and marketed anti-asthmatic drug, may be a promising sex-specific strategy for personalized ALS treatment.

Nanotechnology - An advanced dental innovation

Researchers are interested in exploring the possible uses and advantages of nanotechnology compared to traditional materials, particularly in the domains of dentistry and medicine. The study and creation of materials, tools, systems with distinct biological, chemical, physical characteristics from those found in larger system is known as nanotechnology. Numerous advancements and improvement in oral disease prevention, diagnosis, and treatment are possible because of nanotechnology. Recent Nano - technology breakthrough developments in dentistry are progressively providing a viable therapeutic option for a wide range of dental problems. The purpose of this review was to provide an overview role of nanotechnology in dentistry, as well as to evaluate its application in the prevention and treatment of oral disorders, along with providing crucial new updates on the various nanotechnology – based techniques for dental disease management. The current review will also assist the reader in comprehending Nano science, as well as its benefits and drawbacks, by discussing its ethical, social, and health consequences. In addition, Nano -applications in dental diagnostics and their function in dentistry will be discussed.

Effective treatment with oral Salbutamol on late onset respiratory impairment in a DOK7 Congenital Myasthenia Syndrome: a case report.

DOK7 gene deficiency is a neuromuscular disease with an alteration in post-synaptic neuromuscular junction, leading to progressive respiratory impairment. Although, the therapy is not standardized, adrenergic agonists are suggested as first-line treatment. Case presentation: Our patient had an ambiguous late childhood-onset and had a generalized muscle weakness free of respiratory symptoms during the early phase of the disease. Subsequently, when the respiratory muscle and the diaphragm involvement was impaired, a substantial loss of respiratory function with hypopneas and severe desaturation was detected. It was noteworthy the striking respiratory beneficial impact of oral salbutamol in the resolution of symptoms and functional impairments, leading to a remarkable respiratory improvement and a better quality of life. Conclusion: Oral salbutamol treatment combined to a timely clinical recognition led to an outstanding respiratory improvement.

Relationship of oral bacterial number with medical hospitalization costs in analysis of Diagnosis Procedure Combination database from single institution in Japan

Oral bacteria are known to be associated with perioperative complications during hospitalization. However, no presented reports have clarified the relationship of oral bacterial number with medical costs for inpatients. The Diagnosis Procedure Combination (DPC) database system used in Japan provides clinical information regarding acute hospital patients. The present study was conducted to determine the association of oral bacterial numbers in individual patients treated at a single institution with length of hospital stay and medical costs using DPC data. A total of 2369 patients referred by the medical department to the dental department at Hiroshima University Hospital were divided into the low (n = 2060) and high (n = 309) oral bacterial number groups. Length of hospital stay and medical costs were compared between the groups, as well as the associations of number of oral bacteria with Charlson comorbidity index (CCI)-related diseases in regard to mortality and disease severity. There was no significant difference in hospital stay length between the low (24.3 ± 24.2 days) and high (22.8 ± 20.1 days) oral bacterial number groups. On the other hand, the daily hospital medical cost in the high group was significantly greater (US$1456.2 ± 1505.7 vs. US$1185.7 ± 1128.6, P < 0.001). Additionally, there was no significant difference in CCI score between the groups, whereas the daily hospital medical costs for patients in the high group treated for cardiovascular disease or malignant tumors were greater than in the low number group (P < 0.05). Multivariate regression analysis was also performed, which showed that oral bacterial number, age, gender, BMI, cardiovascular disease, diabetes, malignant tumor, and hospital stay length were independently associated with daily hospitalization costs. Monitoring and oral care treatment to lower the number of oral bacteria in patients affected by cardiovascular disease or cancer may contribute to reduce hospitalization costs.

Pharmacokinetics of N-acetyl-l-cysteine in chickens.

N-acetyl-l-cysteine (NAC) has been suggested as an antioxidant that can alleviate the negative effects of stress conditions in broilers. However, knowledge of its pharmacokinetics (PK) in this avian species is very limited. Therefore, the study aimed to shed more light on the PK properties of NAC in chickens. Broilers were subjected to single intravenous (i.v.) or oral (p.o.) treatment or multiple NAC administrations via the feed. Drug concentrations were determined by LC-MS/MS, and the data were subjected to non-compartmental analysis and modeled by non-linear mixed effect approach. NAC was eliminated in a short time after i.v. treatment, with a t1/2el of 0.93 (0.59-2.09) h. It showed limited distribution with population mean of volumes of distribution in the central and peripheral compartments V1 of 0.148 L/kg and V2 of 0.199 L/kg, respectively, and Vdarea of 0.39 (0.258-0.635) L/kg. The value of MRT was 1.76 h (range of 0.96-2.69, p < .05) after single p.o. treatment, indicating a twofold increase if compared to i.v. administration (0.87 h, 0.55-1.78). Both methods of Pk analysis revealed very limited bioavailability, <10%. Feeding behavior led to a later achievement of lower maximum plasma concentrations (5.74, range of 3.44-9.32 μg/mL, p < .05), which were maintained during the 5 days of treatment.

Investigation on the treatment of empagliflozin in glycogen storage disease type Ib

Objective: To investigate the safety, efficacy and effective dose of empagliflozin in the treatment of glycogen storage disease type Ⅰb (GSD Ⅰb). Method: This was a cross sectional study. A total of 28 children with GSDⅠb who started oral empagliflozin treatment from January 2021 to June 2023 in the WeChat group of patients with glycogen storage disease were selected as the study objects. Clinical data such as general situation, current situation of medication and adverse reactions of the children were collected through questionnaires from June 18 to 30, 2023. The differences of symptoms and laboratory tests before and after empagliflozin treatment were compared by using paired chi-square test and Wilcoxon signed rank sum test. Results: Totally 28 children with GSD Ⅰb were from 12 different provinces, autonomous regions and municipalities in China. There were 14 males and 14 females, Empagliflozin treatment was started at the age of 4.8(2.4, 10.8) years, the time of treatment was 14.5(11.3, 21.5) months, the initial dosage was (0.23±0.11) mg/(kg·d), and the maintenance dosage was (0.28±0.12) mg/(kg·d). Empagliflozin showed positive effects on neutropenia, severity of inflammatory bowel disease like symptoms(Z=-3.70, -2.65, both P<0.05), The proportion of recurrent oral ulcers, recurrent bacterial infections and anemia was significantly lower than that before medication 18% (5/28) vs. (46% (13/28), 14% (4/28) vs. 46% (13/28), 21% (6/28) vs. 46% (13/28), χ²=4.05, 5.26, 3.05, all P<0.05). GCSF was once used in 5 children with GSD Ⅰb, all of them had completely stopped GCSF after empagliflozin treatment. The most common adverse events during empagliflozin treatment were hypoglycemia (5 children) and urinary infection (3 children). All 28 patients had no serious adverse reactions. Conclusions: Empagliflozin can increase the neutrophil count of children with GSD Ⅰb, and had a favorable effect on symptoms such as recurrent oral ulcers, and recurrent infection. The common adverse events during empagliflozin treatment were hypoglycemia and urinary infection.

Increase in gonococcal arthritis in Madrid, Spain, 2022-2023.

In recent years, there has been an increase in Neisseria gonorrhoeae infections in Europe and Spain. Disseminated gonococcal infection is an uncommon clinical presentation that includes gonococcal arthritis. Improved antibiotic treatment has reduced the incidence of gonococcal arthritis. However, the increase in gonococcal infections may have increased the frequency of this clinical entity in recent times. We report five cases of gonococcal arthritis in patients in a tertiary-care hospital in the northern area of Madrid (Spain) from October 2022 to October 2023. Major cases occurred in male patients with unprotected sex and polyarticular symptoms requiring hospital admission and treatment with ceftriaxone and cefixime. The use of molecular techniques has allowed the detection of a greater number of culture-negative cases of gonococcal arthritis, as well as the detection of mutations associated with resistance to fluoroquinolone for switching to oral treatment.

The left atrial appendage closure by surgery 2 trial: statistical analysis plan for a randomized multicenter trial exploring if the closure of the left atrial appendage during open-heart surgery reduces stroke irrespective of patients’ stroke risk and preoperative atrial fibrillation status

BackgroundSurgical left atrial appendage (LAA) closure concomitant to open-heart surgery prevents thromboembolism in high-risk patients. Nevertheless, high-level evidence does not exist for LAA closure performed in patients with any CHA2DS2-VASc score and preoperative atrial fibrillation or flutter (AF) status—the current trial attempts to provide such evidence.MethodsThe study is designed as a randomized, open-label, blinded outcome assessor, multicenter trial of adult patients undergoing first-time elective open-heart surgery. Patients with and without AF and any CHA2DS2-VASc score will be enrolled. The primary exclusion criteria are planned LAA closure, planned AF ablation, or ongoing endocarditis. Before randomization, a three-step stratification process will sort patients by site, surgery type, and preoperative or expected oral anticoagulation treatment. Patients will undergo balanced randomization (1:1) to LAA closure on top of the planned cardiac surgery or standard care. Block sizes vary from 8 to 16. Neurologists blinded to randomization will adjudicate the primary outcome of stroke, including transient ischemic attack (TIA). The secondary outcomes include a composite outcome of stroke, including TIA, and silent cerebral infarcts, an outcome of ischemic stroke, including TIA, and a composite outcome of stroke and all-cause mortality. LAA closure is expected to provide a 60% relative risk reduction. In total, 1500 patients will be randomized and followed for 2 years.DiscussionThe trial is expected to help form future guidelines within surgical LAA closure. This statistical analysis plan ensures transparency of analyses and limits potential reporting biases.Trial registrationClinicaltrials.gov, NCT03724318. Registered 26 October 2018, https://clinicaltrials.gov/study/NCT03724318.Protocol versionhttps://doi.org/10.1016/j.ahj.2023.06.003.

Curcumin mitigates stress induced depression and hippocampal damage through upregulation of BDNF expression and adult neurogenesis.

Chronic stress, recognized as a major precipitant of depression, has been linked to various neural alterations, including cell death, neuronal atrophy, and compromised hippocampal neurogenesis and plasticity. This study aim to scrutinize curcumin's influence on glucocorticoid hormone secretion and its subsequent effects on the structural integrity and neurogenesis of the hippocampal neurons. A total of 30 adult albino Wistar rats, each weighing between 200-250 g, were utilized for the study. The rats, excluding those in the control group, underwent a 42-day regimen of modified Chronic Unpredictable Stress (CUS) to induce depressive-like states. After inducing CUS, these rats were categorized into six groups, each receiving different oral treatments for two weeks. The treatments included 30 mg/kg body weight of curcumin, 20 mg/kg body weight of fluoxetine, or a combination of both, along with a control group that received distilled water and an olive oil treated group. The rats were tested for behavioural despair using the forced swim test and their blood samples were obtained for serum corticosterone test. Afterwards, the rats were anesthetized, transcardially perfused and the hippocampus dissected and prepared for histopathological study. The study's multi-faceted approach encompassed behavioral, biochemical, and histological evaluations. Behavioral despair, gauged through the forced swimming test, displayed a marked reduction in the curcumin-treated rats compared to controls (p&lt;0.05). Additionally, curcumin significantly lowered serum corticosterone levels, aligning them closely with the control levels. Histomorphological analysis of the hippocampus showed that the curcumin- treated rats exhibited substantially less neurodegeneration, as evidenced by fewer cytoplasmic vacuolations and more intact neuronal structures. Increased cell proliferation and BDNF level were also observed in curcumin treated rats. This study has illuminated a multifaceted approach through which curcumin mitigates hippocampal neurodegeneration, thus showing possible therapeutic potential of curcumin in ameliorating depressive symptoms.

Skeletal effects of a prolonged oral metformin treatment in adult Wistar rats.

We previously showed that a 3-week oral Metformin (MET) treatment enhances the osteogenic potential of bone marrow stromal cells (BMSCs) and improves several bone histomorphometric parameters in Wistar rats with metabolic syndrome (MetS). However, the skeletal effects of extended periods of MET are still not completely elucidated. Hence, we investigated the impact of a prolonged (3-month) MET treatment on bone architecture, histomorphometric and biomechanics variables and osteogenic potential of BMSCs in Wistar rats with or without MetS. 36 young male Wistar rats were randomized into four groups (n=9) that received either 20% fructose (F); MET (MET); F plus MET treatments (FMET); or drinking water alone (Veh). Rats were euthanized, blood was collected, and bones were dissected and processed for pQCT analysis, static and dynamic histomorphometry and bone biomechanics. In addition, BMSCs were isolated to determine their osteogenic potential. MET affected trabecular and cortical bone, altering bone architecture and biomechanics. Furthermore, MET increased the pro-resorptive profile of BMSCs. In addition, fructose-induced MetS practically did not affect the skeleton's structural or mechanical variables. A 3-month treatment with MET (with or without MetS) affects bone architecture and biomechanical variables in Wistar rats.

The effect of long-term alendronic acid treatment on Modic changes in the lumbar spine: a gender and age-matched study

BackgroundLow back pain (LBP) affects a significant proportion of the adult population. Potent anti-resorptive drugs such as intravenous zoledronic acid have been demonstrated to reduce Modic changes (MCs) upon magnetic resonance imaging (MRI) of the spine and concomitantly decrease associated LBP. It is uncertain whether oral alendronic acid has a similar effect.Methods82 subjects were recruited in this case-control study. Treatment subjects (n = 41) received oral alendronic acid treatment for at least 1-year and were matched by gender and age (± 2) to control subjects (n = 41) not receiving any anti-osteoporotic medication. The prevalence, type, and extent of MCs were quantified upon T1 and T2-weighted MRIs of the lumbosacral spine.ResultsTreatment subjects received oral alendronic acid for 124.0 ± 62.1 weeks at the time of MRI assessment and exhibited a lower prevalence of MCs over the lumbosacral spine (18/41 vs. 30/41, p < 0.001) as compared to control subjects. Amongst both groups, type 2 MCs were predominant. Quantification of type 2 MCs in treatment subjects revealed a significant reduction in area (113 ± 106 mm2 vs. 231 ± 144 mm2, p < 0.01) and volume (453 ± 427 mm3 vs. 925 ± 575 mm3, p < 0.01) affected by type 2 MCs in comparison to matched controls.ConclusionOral alendronic acid may be useful in the treatment of MC-associated LBP in patients with concomitant osteoporosis.

Unmet Needs and Treatment Preference of Systemic Treatments for Moderate-to-Severe Psoriasis from the Perspectives of Patients and Dermatologists in China.

The treatment options for moderate to severe psoriasis (msPsO) in China have been greatly increased with the approvals of biologics. However, the unmet needs and treatment preferences of systemic treatments for msPsO in China remain unclarified. Fifty dermatologists and 300 patients with msPsO (41% with severe psoriasis) were surveyed for effectiveness, safety, treatment convenience, and treatment preferences (using a choice-based conjoint questionnaire). Descriptive statistics and conjoint simulation analyses were employed to summarize survey information and assess treatment preferences. Both patients and dermatologists reported shorter treatment duration for oral drugs (2.7-6.2months) than that for biologics (9.5-17.0months). The most frequently reported treatment discontinuation reasons by the surveyed patients and dermatologists were unsatisfactory effectiveness (average 84.5%) for oral drugs and loss of efficacy over time (average 68.5%) for biologics. Commonly reported treatment inconveniences included regular lab tests for traditional oral drugs (average 71.5%) and administration assistance for biologics (average 58.0%). Injection site reactions (average 51.5%) and needle fear (average 35.5%) were frequently reported for biologics among the surveyed patients and dermatologists. Once-daily oral treatment was preferred over biweekly subcutaneous injection treatment when the two had comparable attributes (average in patients 87.1% vs. 12.9%; average in dermatologists 93.4% vs. 6.6%). Unmet needs of systemic treatments remain for msPsO in China. Once-daily oral treatment is preferred over biweekly subcutaneous injections to treat msPsO when other treatment attributes are comparable.

Evaluation of children's oral diagnosis and treatment using imaging examination using AI based Internet of Things.

Although cone beam computed tomography (CBCT) plays an important role in the diagnosis and treatment of oral diseases, its image segmentation method needs to be further improved, and there are still objections about the clinical application effect of general anesthesia (GA) on children's dental fear (CDF). This study aimed to investigate the application value of CBCT based on intelligent computer segmentation model in oral diagnosis and treatment of children in the context of biomedical signals, and to analyze the alleviating effect of GA on CDF. Based on the regional level set (CV) algorithm, the local binary fitting (LBF) model was introduced to optimize it, and the tooth CBCT image segmentation model CV-LBF was established to compare the segmentation accuracy (SA), maximum symmetric surface distance (MSSD), average symmetric surface distance (ASSD), over segmentation rate (OR), and under segmentation rate (UR) between these model and other algorithms. 82 children with CDF were divided into general anesthesia group (GAG) (n= 38) and controls (n= 44) according to the voluntary principle of their families. Children in GAG were treated with GA and controls with protective fixed intervention. Children's fear survey schedule-dental subscale (CFSS-DS) and Venham scores were counted before intervention in the two groups. CFSS-DS scores were recorded at 2 hours after intervention and after recovery in children in GAG. CFSS-DS and Venham scores were performed in all children 1 week after surgery. The results showed that the S⁢A value of CV-LBF algorithm was higher than that of region growing algorithm (P< 0.05). OR, UR, MSSD, and ASSD values of CV-LBF algorithm were evidently lower than those of other algorithms (P< 0.05). CFSS-DS scores were lower in GAG than in controls 2 hours after intervention and at return visits after 1 week of intervention (P< 0.001), and Venham scores were lower in GAG than in controls after intervention (P< 0.001). After intervention, the proportion of children with Venham grade 0, 1, 2, and 3 was obviously higher in GAG than in controls (P< 0.001), while the proportion of children with Venham grade 4 and 5 was clearly higher in controls than in GAG (P< 0.001). The results revealed that the computer intelligent segmentation model CV-LBF has potential application value in CBCT image segmentation of children's teeth, and GA can effectively alleviate anxiety of children with CDF and can be used as biomedical signals.

Chronic radiation proctitis refractory to steroid enema was successfully treated by metformin and sodium butyrate: a case report

BackgroundRadiation proctitis (RP) is a significant complication of pelvic radiation. Effective treatments for chronic RP are currently lacking. We report a case where chronic RP was successfully managed by metformin and butyrate (M-B) enema and suppository therapy.Case presentationA 70-year-old Asian male was diagnosed with prostate cancer of bilateral lobes, underwent definitive radiotherapy to the prostate of 76 Gy in 38 fractions and six months of androgen deprivation therapy. Despite a stable PSA nadir of 0.2 ng/mL for 10 months post-radiotherapy, he developed intermittent rectal bleeding, and was diagnosed as chronic RP. Symptoms persisted despite two months of oral mesalamine, mesalamine enema and hydrocortisone enema treatment. Transition to daily 2% metformin and butyrate (M-B) enema for one week led to significant improvement, followed by maintenance therapy with daily 2.0% M-B suppository for three weeks, resulting in continued reduction of rectal bleeding. Endoscopic examination and biopsy demonstrated a good therapeutic effect.ConclusionsM-B enema and suppository may be an effective treatment for chronic RP.