Reduction In PD Research Articles

Clinical and radiographic evaluation of non-surgical therapy with and without ozone gel application in controlled type 2 diabetic patients with periodontitis: a randomized controlled clinical trial

BackgroundThe current study aimed to assess the clinical and radiographic outcomes of the effect of subgingival application of ozonated gel as an adjunct to scaling and root planing (SRP) in diabetic patients with stage III periodontitis.MethodsTwenty-four patients with type II diabetes mellitus (DM) were randomized into two groups, with 12 patients in each group. Group I served as the intervention group, receiving both SRP and ozone gel application (SRP + Ozone), while Group II served as the control group, undergoing SRP alone. Clinical attachment level was evaluated as primary outcome, with secondary outcomes including probing pocket depth, full mouth plaque score, full mouth bleeding score, dentinal hypersensitivity, radiographic linear defect depth, radiographic defect angle, and periodontal ligament widening space assessed at 3 and 6 months.ResultsThe results revealed statistically significant intragroup differences between the two groups (p < 0.05). In contrast, intergroup differences revealed no statistically significant difference across the various time intervals (p > 0.05). The reduction in PD in the SRP + Ozone group at three months was statistically significant (p = 0.04). The SRP + Ozone group showed a significant radiographic improvement compared to the SRP group. The Visual Analogue Scale (VAS) also demonstrated statistically significant differences between the two groups. Glycated hemoglobin (HbA1c) significantly decreased after 6 months, with no significant signifcant differences between groups (p > 0.05).ConclusionsOzone gel is suggested to be a promising potential natural adjunctive therapy for diabetic patients to enhance periodontal health, with no reported adverse effects.Trial registrationID: NCT05538078, Date of Registration: 09/09/2022. (https://register.clinicaltrials.gov/prs/app/action/DownloadReceipt?uid=U0006D54&ts=3&sid=S000CGX4&cx=g1wreh).

Comparison of Conventional and Microsurgical Access Flap Procedure in Managing Chronic Periodontitis: A Randomized Controlled Trial.

The aim of the study was to evaluate and compare the periodontal treatment outcomes in patients with periodontitis treated using conventional and microsurgical access flap procedure. Fifty chronic periodontitis patients were randomly assigned to conventional (Group I) and microsurgical (Group II) open flap debridement procedure. The parameters measured were probing pocket depth, clinical attachment loss (CAL), gingival recession (GR), bleeding on probing (BOP), wound healing, and postoperative pain. PD, CAL, GR, and BOP were assessed at pretreatment (baseline) and 3 months postoperatively. Wound healing was assessed using Landrey et al. healing index at 7th day and 3 months postoperatively and postoperative pain was assessed using number of analgesics taken for 7 days following surgery. Healing Index score of 4 (very good healing) was found in 40% of sites of Group I and 95% of sites of Group II. Comparison of number of analgesics taken between groups on day 7 showed a statistically significant difference (P < 0.01), indicating that pain was significantly reduced in Group II compared to Group I. At 3 months postoperatively, there was no significant reduction in PD, CAL, GR, and BOP between the groups. In open flap debridement procedure, a microsurgical approach can substantially improve the early healing and induce less postoperative pain when compared to a conventional macroscopic approach.

Evaluación comparativa de enjuague bucal con peróxido de hidrógeno y clorhexidina sobre los niveles de interleucina-1ß salival en pacientes con diabetes mellitus tipo 2 y periodontitis crónica: ensayo clínico controlado aleatorio

Introduction: Periodontal inflammation causes dysbiosis and change in the microbiota. Nonsurgical periodontal therapy (NSPT) helps in removal of plaque and restoring periodontal health. Various adjunctive therapy like use of mouthwash helps in maintenance of periodontal health and reducing inflammatory load. Materials and Methods: A total of 108 subjects diagnosed with type 2 diabetes mellitus and periodontitis were divided into three groups: Group 1 received NSPT and rinsing with 0.2% chlorhexidine mouthwash for 3 months, Group 2 received NSPT and rinsing with 1.5% hydrogen peroxide mouthwash for 3 months, Group 3- received NSPT only (control group). The clinical parameters measured included Plaque Index (PI), Gingival Index (GI), Bleeding on probing (BOP) and probing (PD) at baseline, 1, 2, 3 months follow up. Salivary interleukin 1βlevels were measured at baseline and 3 months interval. Results: Group 1, 2 and 3 showed significant reduction in PI, GI, BOP and PD at 1 and 3 months follow up (p&lt;0.05). However, Intergroup comparison of clinical parameters showed significant reduction in group 1 and 2 when compared with group 3 (p&lt;0.05). Salivary interleukin 1-β levels showed significant reduction from baseline to 3 months in all the three groups and intergroup comparison didn’t show any significant changes, (p&gt;0.05). Conclusions: Hydrogen peroxide mouthwash as an adjunct to NSPT can be considered as a safe and effective measure to reduce periodontal inflammation in type 2 diabetes mellitus patients with chronic periodontitis.

Effectiveness of ozone in the management of chronic periodontitis: A clinico-microbiological study

Aim: To evaluate the efficacy of ozonated water with NSPT compared with scaling and root planing (SRP) alone in treating chronic periodontitis. Settings and Design: The current study is a double-masked, randomized clinical trial. Methods and Material: A total of 30 patients aged 25 to 55 years were divided randomly into two groups having probing pocket depths of ≥ 5 mm. Full mouth SRP were performed in group 1 followed by additional sub-gingival irrigation of ozonated water in group 2. Assessment of plaque index (PI), gingival index (GI), probing pocket depth (PPD), and clinical attachment levels (CAL) was performed at baseline and six months. Microbiologic assessment with real-time polymerase chain reaction was performed for Dialister pneumosintes and Micromonas micros by collecting plaque samples. Statistical Analysis Used: The data were subjected to statistical analysis with IBM SPSS Software version 21. The results were presented under the headings of various parameters considered for this study. Results: The results revealed that there was a reduction in PI, GI, PD, CAL, and microbiologic parameters in both groups following SRP; the results were more significant in group 2 treated by sub-gingival irrigation with ozonated water, when compared with SRP alone in group 1. Also, it was noted that there was a statistically significant reduction of M. micros compared to D. pneumosintes in the ozone-treated group. Conclusions: The Subgingival irrigation of ozonated water in conjunction with SRP has beneficial effects in treating patients with chronic periodontitis.

Comparative evaluation of efficacy of subgingivally delivered simvastatin and placebo gel in the treatment of stage ii periodontitis as an adjunct to scaling and root planing and its effect on porphyromonas gingivalis

Aim: To evaluate the clinical efficacy of subgingivally delivered SMV and Placebo gel and compare in the treatment of stage II periodontitis when used as an adjunct to SRP and their antimicrobial effect on the Porphyromonas gingivalis bacteria. Materials &amp; Methods: In a split mouth study design, 10 systemically healthy patients with stage II periodontitis were included in this study based on the inclusion and exclusion criteria. Two sites with deepest pockets were selected. Plaque samples were collected from these pockets at baseline followed by full mouth scaling and root planning, In Group I 1,2% SMV gel and in Group II Placebo gel was placed in the subgingival pockets. Microbiological analysis for Colony Forming Units of P.g was done at baseline after 3 months, Clinical parameters (GI, PI, PD, CAL, mSBI) were evaluated at baseline (before SRP), 1 month and 3 months. Result: Both the groups showed significant reduction in GI, PI, PD, CAL, mSBI and CFU of Pg but Group I showed more significant reduction than Group II.

Postoperative Analgesic and Anti-inflammatory Effectiveness of Ginger (Zingiber officinale) and NSAIDs as Adjuncts to Nonsurgical Periodontal Therapy for the Management of Periodontitis.

The authors hypothesize that ginger (Zingiber officinale) tablets and non-steroidal anti-inflammatory drugs (NSAIDs) are effective in reducing postoperative self-rated pain and periodontal parameters (plaque index [PI], gingival index [GI], and probing depth [PD], clinical attachment loss [AL] and marginal bone loss) following non-surgical periodontal therapy (NSPT) in patients with periodontitis. The aim was to compare the postoperative analgesic and anti-inflammatory effectiveness of ginger tablets and NSAIDs as adjuncts to nonsurgical periodontal therapy for the management of periodontitis. Materials and Methods: Patients with periodontitis were included. All patients underwent NSPT. In groups 1 and 2, patients received postoperative ginger (400 mg) and non-steroidal anti-inflammatory drugs (400 mg), respectively. Demographic data were collected, and full-mouth periodontal parameters (PI, GI, PD and CAL) were evaluated at baseline and at 7, 14 and 21 days. Self-rated pain scores were assessed at baseline, and at 24 h, 3 and 7 days of follow-up. In both groups, self-rated pain was assessed pre- and postoperatively using the numeric rating scale (NRS). Power analysis was performed on data from a pilot investigation and group comparisons were done. Statistical significance was set at p < 0.01. Baseline mean NRS scores in groups 1 and 2 were 4.19 ± 0.12 and 4.13 ± 0.08, respectively. All participants had stage II/grade B periodontitis. At baseline, self-rated pain scores were significantly higher among patients in groups 1 and 2 at 24 h (p < 0.01) and 3 days (p < 0.01) of follow-up. In groups 1 (p < 0.01) and 2 (p < 0.01), self-rated pain scores were significantly higher at 24 h compared with 3 days of follow-up. In both groups, there was a significant reduction in PI (p < 0.01), GI (p < 0.01) and PD (p < 0.01) at 7, 14 and 21 days of follow-up compared with baseline. Ginger and traditional NSAIDs are effective in reducing postoperative pain and inflammation following NSPT in patients with moderate periodontitis.

Comparison of photobiomodulation and photodynamic therapy as adjuncts to mechanical debridement for the treatment of peri-implantitis.

The aim of this study was to compare the efficacy of photobiomodulation therapy (PBMT) and photodynamic therapy (PDT) as adjuncts to mechanical debridement (MD) for the treatment of peri-implantitis. The present study is based on the null hypothesis that there is no difference in the peri-implant inflammatory parameters (modified plaque index [mPI], modified gingival index [mGI], probing depth [PD]) and crestal bone loss (CBL) following MD either with PBMT or PDT in patients with peri-implantitis. Forty-nine patients with peri-implantitis were randomly categorized into three groups. In Groups 1 and 2, patients underwent MD with adjunct PBMT and PDT, respectively. In Group 3, patients underwent MD alone (controls). Peri-implant inflammatory parameters were measured at baseline and 3-months follow-up. P-values < 0.01 were considered statistically significant. At baseline, peri-implant clinicoradiographic parameters were comparable in all groups. Compared with baseline, there was a significant reduction in mPI (P< 0.001), mGI (P< 0.001) and PD (P< 0.001) in Groups 1 and 2 at 3-months follow-up. In Group 3, there was no difference in the scores of mPI, mGI and PD at follow-up. At 3-months follow-up, there was no difference in mPI, mGI and PD among patients in Groups 1 and 2. The mPI (P< 0.001), mGI (P< 0.001) and PD (P< 0.001) were significantly higher in Group 3 than Groups 1 and 2. The CBL was comparable in all groups at follow-up. PBMT and PDT seem to be useful adjuncts to MD for the treatment of peri-implant soft-tissue inflammation among patients with peri-implantitis.

Effect of photobiomodulation after non-surgical mechanical debridement on cortisol levels in the peri-implant sulcular fluid among patients with peri-implant mucositis.

The aim of this was to compare the efficacy of photobiomodulation after non-surgical mechanical debridement (MD) on cortisol levels (CL) in peri-implant sulcular fluid (PISF) among patients with peri-implant mucositis. Patients with peri-implant mucositis were encompassed. All patients underwent non-surgical MD with (test group) and without (control group) a single application of photobiomodulation. Demographic data were collected and PISF was collected. Peri-implant modified plaque index (mPI), modified gingival index (mGI), probing depth and crestal bone loss were measured, and CL in PISF were recorded. All clinical parameters and PISF CL were re-assessed at 4months of follow-up. p<.05showed statistical significance. Seventeen (14 males and 3 females) and 17 (15 males and 2 females) patients with peri-implant mucositis were recruited in test and control groups. The mean age of patients in the test and control groups was 46.1±6.5 and 50.2±2.7years respectively. At baseline, mPI, mGI, PD and PISF volume and CL in control and test groups were similar. At follow-up, there was a significant reduction in mPI (p<.001), mGI (p<.001), PD (p<.001) and PISF volume (p<.001) and CL (p<.001) in both groups compared with baseline. There was no difference in mPI, mGI, PD and PISF volume and CL in test and control groups at follow-up. In short term, non-surgical MD with photobiomodulation does not offer additional benefits in terms of reducing soft-tissue inflammatory parameters and PISF CL in patients with peri-implant mucositis.

Alpha-synuclein oligomers and small nerve fiber pathology in skin are potential biomarkers of Parkinson\u2019s disease

The proximity ligation assay (PLA) is a specific and sensitive technique for the detection of αSyn oligomers (αSyn-PLA), early and toxic species implicated in the pathogenesis of PD. We aimed to evaluate by skin biopsy the diagnostic and prognostic capacity of αSyn-PLA and small nerve fiber reduction in PD in a longitudinal study. αSyn-PLA was performed in the ankle and cervical skin biopsies of PD (n = 30), atypical parkinsonisms (AP, n = 23) including multiple system atrophy (MSA, n = 12) and tauopathies (AP-Tau, n = 11), and healthy controls (HC, n = 22). Skin biopsy was also analyzed for phosphorylated αSyn (P-αSyn) and 5G4 (αSyn-5G4), a conformation-specific antibody to aggregated αSyn. Intraepidermal nerve fiber density (IENFD) was assessed as a measure of small fiber neuropathy. αSyn-PLA signal was more expressed in PD and MSA compared to controls and AP-Tau. αSyn-PLA showed the highest diagnostic accuracy (PD vs. HC sensitivity 80%, specificity 77%; PD vs. AP-Tau sensitivity 80%, specificity 82%), however, P-αSyn and 5G4, possible markers of later phases, performed better when considering the ankle site alone. A small fiber neuropathy was detected in PD and MSA. A progression of denervation not of pathological αSyn was detected at follow-up and a lower IENFD at baseline was associated with a greater cognitive and motor decline in PD. A skin biopsy-derived compound marker, resulting from a linear discrimination analysis model of αSyn-PLA, P-αSyn, αSyn-5G4, and IENFD, stratified patients with accuracy (77.8%), including the discrimination between PD and MSA (84.6%). In conclusion, the choice of pathological αSyn marker and anatomical site influences the diagnostic performance of skin biopsy and can help in understanding the temporal dynamics of αSyn spreading in the peripheral nervous system during the disease. Skin denervation, not pathological αSyn is a potential progression marker for PD.

Effect of multiple sessions of photodynamic therapy on bone regeneration around dental implants among patients with peri‑implantitis

ObjectiveThe aim of the present study was to assess the effect of multiple sessions of antimicrobial photodynamic therapy (aPDT) on bone regeneration around dental implants among patients with peri‑implantitis. MethodsPatients with peri‑implantitis were included. Therapeutically, patients were randomly divided into 4 groups: (a) Group-I: Mechanical debridement (MD) alone; (b) Group-II: MD at baseline followed by a single session of adjunct a PDT; (c) Group-III: MD at baseline followed by aPDT at baseline and at 3-months of follow-up; and Group-IV: MD at baseline followed by aPDT at baseline and at 3- and 6-months of follow-up. Demographic data was collected and peri‑implant clinical (plaque index [PI], gingival index [GI], and probing depth [PD]) and radiographic (crestal bone loss [CBL]) parameters were assessed at baseline and after 9 months. Sample-size estimation was done on data from a pilot investigation and group comparisons were done using one-way analysis of variance and Bonferroni post-hoc adjustment tests. Level of significance was set at P<0.01. ResultsTwenty-two, 22, 22 and 22 patients with peri‑implantitis were enrolled in groups -I, -II, -III and -IV. The mean age of individuals in groups -I, -II, -III and -IV were 59.2 ± 5.3, 60.5 ± 2.8, 59.6 ± 3.1 and 58.7 ± 0.8 years, respectively. Compared with Group-I, there was a statistically significant reduction in PI (P<0.01), GI (P<0.01) and PD (P<0.01) in all groups at 9-months follow-up. There was no significant difference in PI, GI and PD in groups -II, -III and -IV at 9-months follow-up. There was no statistically significant difference in CBL in all groups at baseline and at 9-months-follow-up. ConclusionThe use of aPDT as an adjunct to MD reduces the severity of peri‑implant mucositis but does not contribute towards bone regeneration in peri‑implant osseous defects.

Clinical, bacterial, and inflammatory outcomes of indocyanine green-mediated photodynamic therapy for treating periimplantitis among diabetic patients: A randomized controlled clinical trial

Background This 6-months randomized controlled clinical trial aimed to assess the efficacy of indocyanine green mediated photodynamic therapy (ICG-PDT) as an adjunct to peri‑implant manual debridement (PIMD) versus PIMD alone among Diabetes Mellitus (DM) patients in the treatment of peri‑implantitis.Methods A total of 48 DM patients having 64 implants were treated with either ICG-PDT + PIMD (n = 35 implants) or PIMD alone (n = 29 implants). Clinical (probing depth [PD], bleeding on probing [BOP], and plaque index [PI]) and radiographic (peri‑implant crestal bone loss [PCBL]) peri‑implant variables were recorded. Bacterial species including Porphyromonas gingivalis and Treponema denticola were evaluated from peri‑implant plaque biofilms. Levels of interleukin (IL)-1β and IL-6 were assessed after the collection of peri‑implant sulcular fluid. All the evaluations were carried out at baseline, 3- and 6-months. The significance level was set to p < 0.05.Results All clinical parameters significantly reduced within both treatment groups (P<0.05). Intra-group comparison indicates that there was statistically significant reduction in PD and suppuration for ICG-PDT group (P<0.05). There was a statistically significant difference in the BOP between ICG-PDT and PIMD groups at both follow-up periods (P<0.001). However, there was a significant difference for PD (P = 0.001), suppuration (P = 0.01), and PCBL (P = 0.04) on 6 months follow-up between ICG-PDT and PIMD groups, respectively. Only ICG-PDT showed a significant reduction in P. gingivalis and T. denticola on both 3 months and 6 months follow-up compared to baseline. PIMD showed a statistically significant reduction only on 3 months follow-up compared to baseline. This reduction was maintained for both the species when dental implants were treated with ICG-PDT. However, PIMD failed to maintain this reduction until 6 months. Only at 3 months assessment that both treatment groups showed statistically significant reduction in IL-1β and IL-6 with no significant difference between the groups. Both biomarkers failed to maintain the reduction in both groups and significantly increased levels for IL-1β was noted at 6 months follow upConclusion Multiple application of indocyanine-green mediated photodynamic therapy resulted in improved clinical and microbial parameters among type 2 DM subjects in the treatment of peri‑implantitis.This clinical trial was registered in the ClinicalTrials.gov Protocol Registration and Results System with registration record number: NCT04833569

122 A Mechanistic Model of Growth and Amino Acid Deposition in the Pregnant Sow: Model Development, Evaluation, and Application

Abstract A mechanistic model was developed with the objective to characterize weight gain and essential amino acid (EAA) deposition in the different tissue pools that make up the pregnant sow: placenta, allantoic fluid, amniotic fluid, fetus, uterus, mammary gland, and maternal body were considered. The data used in this modelling approach were obtained from published scientific articles reporting weights, crude protein (CP), and EAA composition in the previously mentioned tissues; studies reporting not less than 5 datapoints across gestation were considered. A total of 12 scientific articles published between 1977 and 2020 were selected for the development of the model and the model was validated using 11 separate scientific papers. The model consists of three connected sub-models: protein deposition (Pd) model, weight gain model, and EAA deposition model. Weight gain, Pd, and EAA deposition curves were developed with nonparametric statistics using splines regression. The validation of the model showed a strong agreement between observed and predicted growth (r2 = 0.92, root mean square error = 3%). The proposed model also offered descriptive insights into the weight gain and Pd during gestation. The model suggests that the definition of time-dependent Pd is more accurately described as an increase in fluid deposition during mid-gestation coinciding with a reduction in Pd. In addition, due to differences in CP composition between pregnancy-related tissues and maternal body, Pd by itself may not be the best measurement criteria for the estimation of EAA requirement in pregnant sows. The proposed model also captures the negative maternal Pd that occurs in late gestation and indicates that litter size influences maternal tissue mobilization more than parity. The model predicts that the EAA requirements in early and mid-gestation are 75, 55 and 50% lower for primiparous sows than parity 2, 3 and 4+ sows, respectively, which suggest the potential benefits of parity segregated feeding.

Effect of Locally Delivered Melatonin as an Adjunct to Nonsurgical Therapy on GCF Antioxidant Capacity and MMP-9 in Stage II Periodontitis Patients: A Randomized Controlled Clinical Trial.

Objectives Periodontitis is characterized by inflammatory destruction of periodontal tissue, loss of attachment, and bone resorption. The increase in reactive oxygen species (ROS) is responsible for the oxidative damage occurring in periodontal tissues. Melatonin has important immunomodulatory, anti-inflammatory, and powerful antioxidant functions. The current study was carried out to evaluate the effect of topical melatonin gel as an adjunct to nonsurgical periodontal therapy. Methods This split-mouth randomized controlled clinical trial was performed on 24 patients with grade II periodontitis. Two sites in each patient were randomly assigned; test sites were treated by nonsurgical therapy followed by intrapocket application of 5% melatonin gel. Control sites were treated by nonsurgical therapy followed by intrapocket application of placebo gel. Both the melatonin and placebo gel were applied weekly once for four weeks. Assessment of clinical parameters (PD and CAL) was done at baseline and 3 months after therapy. Total antioxidative capacity (TAC) and matrix metalloproteinase-9 (MMP-9) levels in GCF were also evaluated utilizing commercially available enzyme-linked immunosorbent assay kits (ELISA) at baseline and 3 months after therapy. Results Treatment with topical melatonin was associated with a reduction in periodontal inflammation reflected as an improvement in the clinical periodontal parameters. Melatonin-treated sites showed a more statistically significant percent reduction in PD and more statistically significant percent gain in CAL than the control site. Additionally, a significant increase in TAC and a significant decrease in MMP-9 levels in GCF were found in melatonin-treated sites in comparison to control sites. Conclusions The adjunctive use of topical melatonin gel with nonsurgical periodontal therapy has potent anti-inflammatory and antioxidant activity in the treatment of grade II periodontitis patients.

Dehydrated Human Amnion-Chorion Product as an Adjunct to Scaling and Root Planing inMaintenance Patients: A Pilot Study

Background: Adjunctive therapies are often combined with Scaling and Root Planing (SRP) procedures to limit bacterial recolonization of periodontal pockets and to modulate the wound healing environment. While local delivery antimicrobial therapies are effective, they do not promote soft tissue repair at these sites. BioXclude, a dehydrated human de-epithelialized amnion-chorion membrane product (ddACM) sourced from donated human placental tissue, has been shown to have antimicrobial properties, contain stimulatory growth factors known to activate wound healing processes, and possess critical attachment substrates for cellular adhesion and migration. Given this combination, it was hypothesized that ddACM would be an effective adjunctive therapy for the treatment of periodontal pockets following SRP procedures. Methods: Sixteen non-smoking patients, compliant with a regular periodontal maintenance program, were included in this study. A total of 30 sites showing a ≥ 2 mm increase in periodontal probing depth (PPD), with associated bleeding on probing (BOP), were chosen for treatment. Following standard SRP procedures with local anesthesia, ddACM was placed into the treated area. A six-week periodontal re-evaluation was completed, with the primary outcome variable being PD reduction and secondary outcomes that included resolution of bleeding on probing (BOP). Results: Mean PD reduction was 2.55 mm ± 0.34 mm, with three sites showing ≥ 4 mm ± 0.2 mm reduction in PD. BOP was resolved in 83% of the treated sites. Conclusion: ddACM provides significant benefit as an adjunctive therapy to SRP for the treatment of periodontal pockets in terms of PD reduction and resolution of BOP.

Estimation of plasma levels of fibrinogen in patients with periodontitis: An intervention study

Aims: This study was conducted to investigate the effect of nonsurgical periodontal therapy on plasma levels of fibrinogen in patients with chronic periodontitis and its association. Materials and Methods: Twenty otherwise healthy subjects with chronic periodontitis were recruited for this intervention study. Both clinical parameters and blood were collected at baseline and one month, three months after nonsurgical periodontal therapy (scaling, root planning, and oral hygiene instructions). Periodontal examination included PD, CAL, PI, GI, and blood; these were analyzed to determine plasma fibrinogen. The effect of treatment was assessed by paired t-test; correlation between blood and clinical parameters was assessed by Pearson’s correlation. Results: There was a significant reduction in PD, CAL, PI, and GI at one month and three months after periodontal therapy (P < 0.001); plasma fibrinogen levels significantly decreased at one month and three months after treatment (P < 0.001). Also, a significant correlation was seen between clinical parameters and fibrinogen levels at different intervals of time. Conclusion: In patients with chronic periodontitis, nonsurgical periodontal therapy significantly reduced fibrinogen levels after one month and three months and it may, thus, decrease their risk of coronary heart disease.

Effects of angiotensin receptor neprilysin inhibition on P-wave dispersion in heart failure with reduced ejection fraction.

Angiotensin receptor neprilysin inhibitors (ARNI; sacubitril/valsartan combination) decrease morbidity and mortality in heart failure with reduced ejection fraction (HFrEF). Increased P‑wave duration and P‑wave dispersion (Pd) reflect prolongation of atrial conduction and correlate with atrial fibrillation. Here, we aimed to assess the effects of switching from valsartan to ARNI treatment on the basis of P‑wave indices. Atotal of 28patients with HFrEF (mean age, 64.8 ± 10.6years; 18males, 78.6% ischemic etiology) were included. All patients had New York Heart Association functional classII-III, left ventricular ejection fraction ≤35%, and had been switched from valsartan to ARNI treatment. Standard 12-lead electrocardiograms from patients on valsartan treatment and electrocardiograms 1month after ARNI treatment were analyzed; heart rate, maximum P‑wave duration (Pmax), minimum P‑wave duration (Pmin), and Pd were calculated. Minnesota Living with Heart Failure Questionnaire (MLWHFQ) scores and N‑terminal pro-brain natriuretic peptide (NT-proBNP) values were recorded. The Pmax (135.6 ± 32.1 ms vs. 116.1 ± 14.1 ms, p = 0.041) and Pd (33.6 ± 7.9 vs. 28.6 ± 5.3, p = 0.006) values were significantly reduced after ARNI treatment. Furthermore, ARNI treatment was associated with an improvement in MLWHFQ scores (31.2 ± 6.2 ms vs. 23.2 ± 7.0 ms, p < 0.001) and with areduction in NT-proBNP values (1827.3 ± 1287.3 pg/ml vs. 1074.4 ± 692.3 pg/ml, p < 0.001). There were moderately positive correlations between the reduction in Pd and the improvement in MLWHFQ scores (r = 0.408, p = 0.031) and the reduction in NT-proBNP values (r = 0.499, p = 0.007) CONCLUSION: Switching to ARNI treatment alters Pd and Pmax favorably in patients with HFrEF. The reduction in atrial inhomogeneous conduction assessed by Pd was correlated with clinical improvement and reduced NT-proBNP levels in patients with HFrEF.

Predictors of motor complications in early Parkinson's disease: A prospective cohort study.

ObjectiveThe objective of this study was to identify clinical predictors of motor complications (dyskinesia and motor fluctuations) of levodopa in a prospectively recruited PD cohort using longitudinal analysis.MethodsAn inception cohort (Oxford Discovery) of 734 patients was followed to a maximum of 10 years from diagnosis using a discrete‐time survival analysis. A subset analysis was used to validate an online dyskinesia‐risk calculator developed from the results of the Stalevo Reduction in Dyskinesia Evaluation PD trial.ResultsA total of 186 cases of dyskinesia and 254 cases of motor fluctuations were observed. Dyskinesia incidence increased with time (risk per 100 participants [95% confidence interval] 13 [11–16] <3.5 years, 16 [13–21] 3.5–5.0 years, 19 [14–26] 5–6.5 years, and 23 [16–33] >6.5 years from diagnosis). Motor complication predictors were grouped as medication predictors, disease predictors and patient predictors. Baseline nonmotor feature severity, low mood, anxiety, and age at symptom onset were associated with motor complications among a number of previously identified predictors. Replication of the Stalevo Reduction in Dyskinesia Evaluation PD calculator was reasonable with the area under the curve for dyskinesia risk score as a predictor of dyskinesia being 0.68 (95% confidence interval, 0.55–0.81).ConclusionsThis study quantifies risk of motor complications, finds consistent predictors, and demonstrates the novel finding that nonmotor features of PD, particularly low mood and anxiety, are significant risk factors for motor complications. Further validation of dyskinesia risk scores are required as well as evidence to determine if the routine use of such scores can be clinically valuable in enhancing patient care and quality of life. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

Preparation of Ce0.5Zr0.5O2–Al2O3 with high-temperature sintering resistance and its supported Pd-only three-way catalyst

In this study, three Ce0.5Zr0.5O2–Al2O3 composites were synthesized using co-precipitation method with different precursor mixing ways. Differences in structural, textural, reduction properties and catalytic performance, in combination with the aging behaviors of the supports and catalysts, were systematically explored. For CZA4, Al(NO3)3·9H2O was mixed with Ce(NO3)3·6H2O and ZrOCO3 separately before being precipitated; it could inhibit the phase separation and crystalline growth as well as exhibit resistance against sintering. Besides, CZA4 exhibited the higher surface Ce3+ species and Ce surface content, which was more beneficial to improve the redox performance. In addition, the as-prepared Pd/CZA4 and Pd/CZA4a also presented superior redox performance and Pd dispersion. What is more, the increase of Pd–Ce interface may be caused by the high Ce content on the surface, consequently, enhancing reduction in Pd–Ce interaction and dispersion of precious metal. Due to a series of properties after aging for CZA4a, thus the Pd–CZA4a revealed good TWCs performance.

Extraction chromatography–electrodeposition (EC–ED) process to recover palladium from high-level liquid waste

The extraction chromatography–electrodeposition (EC–ED) process was proposed for the quantitative recovery of palladium from high-level liquid waste (HLLW) in this study. The process coupled the extraction chromatography method to obtain the decontamination of Pd(II) from HLLW with the electrochemical method to recover metallic palladium from the concentrated solution. Separation of Pd(II) from a nitric acid medium by extraction chromatography using isoBu-BTP/SiO2-P adsorbent and the electrochemical behavior of Pd(II) in nitric acid solution in the presence of thiourea (TU) were investigated. isoBu-BTP/SiO2-P exhibited a high selectivity for Pd(II) over other fission products (FPs), and Pd(II) could be desorbed by TU from loaded BTP/SiO2-P. The adsorbent performed good stability against HNO3 because the adsorption performance kept Pd(II) after extended contact with HNO3 solution. The column experiment achieved the separation of Pd(II) from simulated HLLW successfully. The electrochemical behavior of Pd(II) in palladium desorption solution containing TU and nitric acid was investigated at a platinum electrode by cyclic voltammetry. A weak reduction wave at − 0.4 V was due to the reduction in Pd(II) to Pd(0), and the deposition process was irreversible. In electrowinning experiments, a maximum of 92% palladium could be obtained.

Photometric CIELAB Analysis of the Gingiva: A Novel Approach to Assess Response to Periodontal Therapy.

A new photometric method is introduced for assessment of gingival condition and changes after periodontal therapy. Clinical data (probing depth [PD], plaque index [PI], gingival index [GI], bleeding on probing [BOP], and clinical attachment level) and photographs from 53 participants (26 males and 27 females) undergoing initial periodontal treatment were used for this analysis. Each maxillary anterior area was photographed before and 3 months after treatment. Digital image analysis was performed around one incisional tooth, and color data were expressed in terms of L*, a*, and b* values in accordance with the CIELAB color space. Non-parametric Mann-Whitney U test was used for within-group comparisons of disease resolution, as well as means and standard deviations of clinical parameters and ΔL, Δa, and Δb values from baseline to re-evaluation. Significant reduction in mean PI, GI, PD, and BOP were found after treatment in all groups (P <0.001). Significant differences (P <0.05) were recorded by diagnosis of chronic periodontitis in the a* coordinate when comparing treatment results with the baseline (P <0.004). Results of this study suggest potential benefit in using photometric analysis to assess gingival changes after therapy.