Regrowth Rate Research Articles

Efficacy of Lauromacrogol Injection for Ablation of Benign Predominantly Cystic Thyroid Nodules and Related Factors: A Prospective Study.

ObjectiveTo prospectively evaluate the efficacy of lauromacrogol injection for ablation (LIA) of benign predominantly cystic thyroid nodules and its related factors.Materials and MethodsA total of 142 benign predominantly cystic thyroid nodules (median volume, 12.5 mL; range, 0.4–156 mL) in 137 patients (male:female sex ratio, 36:101; mean age ± standard deviation [SD], 49 ± 13 years) were treated with LIA after being confirmed as benign via cytology. The volume reduction rate (VRR) of the nodules and cosmetic score were evaluated during follow-up at 1, 3, and 6 months after treatment and every 6 months thereafter. A VRR of ≥ 50% at the 12-month follow-up was considered to indicate effective treatment. The associations between the clinical factors and nodular ultrasound features, including the initial nodule volume, proportion of solid components, vascularity grade and ineffective treatment (VRR of < 50% at the 12-month follow-up), and regrowth were analyzed.ResultsAll patients completed follow-up for at least 12 months. The average ± SD follow-up period was 32 ± 11 months (range, 12–54 months). The effective treatment rate was 73.2% (104/142), while the regrowth rate was 12.0% (17/142) at the last follow-up. Grade 2–3 intranodular vascularity in the solid components of the nodules was the only independent factor associated with ineffective treatment, with an odds ratio (reference category, grade 0–1) of 3.054 (95% confidence interval, 1.148–8.127) (p = 0.025).ConclusionLIA is an effective treatment for predominantly cystic thyroid nodules. Grade 2–3 intranodular vascularity in the solid components of nodules is the only independent risk factor for ineffective LIA.

Ten Years Assessment of Shifting Cultivation on Land Cover and Carbon Storage in Timor Island, Indonesia

The practice of shifting cultivation has led to forest degradation and deforestation in the Sisimeni Sanam Forest Area, with Special Purpose (SSFAwSP). Therefore, this study aims to assess land cover and carbon storage changes of the practiced shifting cultivation in SSFAwSP over the last ten years using 2013, 2016, and 2021 Landsat imagery. A hybrid classification approach that combines the forest canopy density model and supervised classification of maximum likelihood was used to create land cover maps to detect changes in forest land cover and carbon storage. The results showed that for ten years, the extent and annual rates of deforestation, forest degradation, forest regrowth, and changes in carbon storage were 662.62 ha (4%), 319.18 ha (3%), 163.8 ha (1%), and -54.51 kilo Ton C (3%), respectively. This finding indicated that shifting cultivation contributed only 10% and 1% of total deforestation and forest degradation, respectively.

Soft tissue re-growth after different crown lengthening techniques among Indian patients.

Patients often report complaining of fractured or decayed teeth with severe morphological deformities. However, all these clinical scenarios require the same level of care and consideration to rehabilitate form, function and esthetics. Some cases have sufficient clinical crown height while others often require an interdisciplinary approach in the form of orthodontic/surgical extrusion or surgical periodontal options. A common factor delaying treatment is soft tissue regrowth after crown lengthening which delays the impression required for final prosthesis. Therefore, it is of interest to compare the prevalence of soft tissue regrowth a week after different crown lengthening techniques including laser gingivectomy, electrocautery gingivectomy, modified Widman flap and apically repositioned. The parameters assessed included 1-week postoperative soft tissue regrowth after crown lengthening, age of patients and gender. It was observed that laser and electrocautery-assisted gingivectomy had a higher rate of soft tissue regrowth as compared to surgical techniques. It was further noted that laser and electrocautery assisted gingivectomy had a higher frequency of soft tissue rebound growth compared to surgical crown lengthening using modified widman flap and apically repositioned flap, which was statistically insignificant. Patients within the age groups of 26-60 years were found to have a higher tendency of soft tissue regrowth, which was found to be clinically and statistically significant (p<0.05).

Watch and wait strategies for rectal cancer: A systematic review

Watch and wait (WW) strategies have been suggested for patients with clinical complete regression (cCR). The WW approach was first introduced by Habr–Gama in patients with cCR after neoadjuvant treatment. Actually, it is not “no surgery” but “deferral of surgery;” therefore, the WW approach or non-operative management is a representative term currently. The number of publications regarding WW for rectal cancer has increased abruptly. We conducted a systematic review of PubMed for literature published on WW. It is now one of the most interesting issues in rectal cancer treatment. Many studies have reported comparable overall survival with WW and radical resection. However, a high local regrowth rate is a problem, and proper salvage management is the main concern in the WW approach. Adequate patient selection is necessary to achieve favorable oncologic outcomes. However, the appropriate definition and diagnostic method for cCR have not yet been clearly defined. Indeed, advances in local control have not translated into overall survival improvement, and many efforts have been made to improve distant metastasis control and overall survival and improve clinical response to preoperative chemoradiotherapy. In this review, oncologic outcomes, ongoing efforts to improve oncologic outcomes, and limitations for clinical practice were evaluated and described.

Is It Possible to Produce Certified Hazelnut Plant Material in Sicily? Identification and Recovery of Nebrodi Genetic Resources, in vitro Establishment, and Innovative Sanitation Technique From Apple Mosaic Virus.

Eight Sicilian cultivars of hazelnut (Corylus avellana L.), namely-Curcia, Nociara Collica, Panottara Collica, Panottara Galati Grande, Parrinara, Panottara Baratta Piccola, Enzo, and Rossa Galvagno, registered into the Italian Cultivar Register of fruit tree species in 2017 were selected from Nebrodi area and established in vitro. The aim of the work was to carry out the sanitation of the cultivars and get virus-free plants from the most important viral pathogen threat, the apple mosaic virus. Virus-free plant material is essential for the production of certified plants from Sicilian hazelnut cultivars, complying the CE (cat. CAC) quality and the technical standards established in 2017 for voluntary certification by the Italian Ministry of Agricultural, Food and Forestry Policies (MIPAAF). In this study, we investigated the possibility of establishing in vitro true-to-type and virus-free hazelnut plantlets via the encapsulation technology of apexes. The in vitro shoot proliferation rates were assessed for the different cultivars, sampling periods, temperature treatments, and type of explant used for culture initiation. Viability, regrowth, and conversion rates of both conventional meristem tip culture (MTC) and not conventional (MTC combined with the encapsulation technology) sanitation techniques were evaluated.

Evaluation of regrowth ability of soybeans for forage utilization under two-cutting systems

Soybean (Glycine max) has the potential as forage feed because of its high protein content and low fiber. Intercropping soybean with tropical forage grasses can improve forage quality and increase yield. However, their optimum cutting interval under mixed cropping system is still unknown. This study aimed to investigate regrowth ability and performance of soybean plant under two different cutting heights in Miyazaki, Southwestern of Japan, which has a humid subtropical climate with relatively high temperature and evenly distributed precipitation throughout the year. The experimental design was randomized block design arrange in 3  2 factorial scheme (soybean cultivars  cutting treatments). Three soybean accessions (Glycine max ‘Fukuyutaka’, G. max ‘Kohamdaizu’ and G. gracilis ‘Moshidou Gong 503’) with 5 replications were cultivated under single seeding condition. Soybeans were defoliated after 50 d of cultivation under low level cutting height (LC, 7.5 cm) and high level cutting height (HC, 12 cm). ‘Fukuyutaka’ achieved 100% regrowth rate in both LC and HC. Although the regrowth rate for ‘Kohamadaizu’ was 100% in the HC, it was only 20% in LC. ‘Fukuyutaka’ was more robust and high tolerant for defoliation stress than that of ‘Kohamadaizu`. In other hand, no plants exhibited regrowth in both cutting heights for ‘Moshidou Gong 503’. For ‘Fukuyutaka’ and ‘Kohamadaizu’, the number of branching nodes with re-emergent leaves was significantly higher in the HC. In both cutting height of ‘Fukuyutaka’, plant continued elongating and exhibited vigorous growth until 2nd cutting. The cutting height levels, height of cotyledonary node and growth stage of soybean plant when harvested at the 1st cutting significantly affected the regrowth ability of soybeans. In conclusion, ‘Fukuyutaka’ showed the ability for regrowth under LC and HC. HC provided significantly higher fresh matter and dry matter weight than that LC. Further study is needed to evaluate the performance of ‘Fukuyutaka’ under intercropping cultivation with tropical forage grasses. This is the first report to establish an approach for two-cutting soybean as forage

Placebo group regrowth rate in alopecia areata clinical trials: A systematic review and meta-analysis

To the Editor: Alopecia areata (AA) is an autoimmune disorder that causes hair loss and has an unpredictable course.1 The identification of Janus kinase inhibitors for use in patients with AA has led to multiple studies evaluating novel therapeutics.2 Although placebo-controlled trials remain the gold standard, recruiting and maintaining patients to receive placebo treatment can be challenging because patients may be subjected to months of therapy, with no potential benefit. Herein, we assessed placebo group regrowth rates (PGRRs) across AA clinical trials.

Novel Pathways for Targeting Tumor Angiogenesis in Metastatic Breast Cancer.

Breast cancer is the most common cancer affecting women and is the second leading cause of cancer related death worldwide. Angiogenesis, the process of new blood vessel development from pre-existing vasculature, has been implicated in the growth, progression, and metastasis of cancer. Tumor angiogenesis has been explored as a key therapeutic target for decades, as the blockade of this process holds the potential to reduce the oxygen and nutrient supplies that are required for tumor growth. However, many existing anti-angiogenic approaches, such as those targeting Vascular Endothelial Growth Factor, Notch, and Angiopoietin signaling, have been associated with severe side-effects, limited survival advantage, and enhanced cancer regrowth rates. To address these setbacks, alternative pathways involved in the regulation of tumor angiogenesis are being explored, including those involving Bone Morphogenetic Protein-9 signaling, the Sonic Hedgehog pathway, Cyclooxygenase-2, p38-mitogen-activated protein kinase, and Chemokine Ligand 18. This review article will introduce the concept of tumor angiogenesis in the context of breast cancer, followed by an overview of current anti-angiogenic therapies, associated resistance mechanisms and novel therapeutic targets.

Changes of surface recovery at coseismic landslides and their driving factors in the Wenchuan earthquake-affected area

A major earthquake can trigger numerous landslides, which exert severe impacts on regional vegetation coverage. In some years following an earthquake, rainstorms can easily reactivate coseismic deposits and unstable hillslopes. Vegetation can improve the post-seismic slope instability by the root reinforcement effect, and it is significant to investigate the changes of surface recovery at coseismic landslides for a long-term assessment of post-earthquake geohazards. However, due to limited earth observations, it remains elusive that how long the surface vegetation of coseismic landslides caused by the 2008 Wenchuan earthquake will recover to the pre-earthquake level. We studied the long-term evolution of surface recovery in coseismic landslide-affected areas using multi-temporal Landsat images from 2000 to 2020. We calculated the vegetation recovery rates in different periods, which were used to quantify the rate of vegetation regrowth and landslide activity intensity. We found that 71.34% of the affected areas have been properly revegetated, and the area percentage of landslides in high activity, middle activity, low activity and dormant were 17.6%, 12.4%, 17.7% and 52.3%, respectively in 2020. To examine the factors controlling the surface recovery at coseismic landslides, we further analyzed the relationships between landslide recovery and eighteen influencing factors, and we found that elevation, peak ground acceleration, rainfall, lithology and gully density are the key factors that control landslide surface recovery over all others. Overall the trend of surface recovery at coseismic landslides suggests that the impact of the Wenchuan earthquake on the activities of shallow landslides almost ceases within 17 years in the Wenchuan earthquake-affected areas.

Extracapsular versus intracapsular tonsillectomy: Outcomes in children with a focus on developmental delay

IntroductionOutcomes following intracapsular tonsillectomy (IT) have not been well established in children with developmental delays. The objective of this study was to compare outcomes and complications between intracapsular and extracapsular tonsillectomy (TT) in pediatric patients with developmental delay (DD) in comparison to non-developmentally delayed children. MethodsThis is a retrospective study of pediatric patients with DD undergoing tonsillectomy between 2016 and 2019 at a tertiary care hospital. This group included patients with Down Syndrome, Autism Spectrum Disorder, other genetic syndromes, and patients with a diagnosis of global developmental delay. Outcomes and complications were analyzed for IT and TT. Results2267 charts were reviewed, and 320 patients were identified with DD. Of those, 72 patients underwent IT and 248 underwent TT. In the DD cohort, the IT group had a shorter length of stay (0.97 vs 1.7 days, p < .0001) and was less likely to receive post-operative narcotic medication (2.8% vs 35%, p < .0001) and corticosteroids (9.7% vs 64%, p < .0001) during their hospital stay. Reductions in emergency room (ER) visits (5.6% vs 10%, p = .21) and post-op bleeding (PTH) (1.4% vs 4.8%, p = .31) for IT vs TT were not statistically significant in the DD group. In the NDD group, fewer patients undergoing IT returned to the ER (11% vs 2.3%, p < .0001) or had PTH (4.8% vs 0.25%, p, 0.0001) as compared to those children undergoing TT. There was no difference between parental report of symptom improvement between the groups (39% vs 33%, p = .39). Analysis of 180 patients with preoperative and postoperative sleep study data revealed post-op Apnea Hypopnea Index (AHI) improved with both techniques (74% TT vs 79% IT, p = .7). There were no differences noted for persistent obstructive sleep apnea (OSA) among the two techniques for both study groups (p = .63). ConclusionChildren with DD undergoing IT have reduced length of stay and reduced inpatient administration of post-operative opioids and steroids. IT has comparable efficacy to TT in treating symptoms of pediatric sleep apnea with a better safety profile. Overall, children undergoing IT return to the operating room less frequently than those undergoing TT. Longer follow-up studies will be needed to evaluate rate of tonsil regrowth, risk of revision surgery and persistence of OSA in these patients.

Quantification of Target Volume Changes on Radiation Planning MRI in IDH-Wildtype Glioblastoma

IDH-wildtype glioblastoma (GBM) has an exceptionally poor prognosis due to its rapid growth. Delaying post-operative radiation therapy (RT) more than 6 weeks after surgery negatively impacts prognosis. Post-operative magnetic resonance imaging (MRI) is commonly used to assess the extent of surgical resection followed by a delayed MRI for RT planning. In a heterogeneous population of high-grade gliomas treated in the pre-molecular era, significant resolution of edema and a trend towards increase in surgical cavity sizes were observed. Post-operative volumetric changes in IDH-wildtype GBM have not been described and we suspect these tumors may demonstrate higher rates of recurrence or regrowth during the latent period before the initiation of RT.30 patients with IDH-wildtype GBM treated with post-operative RT from our institution were identified. Patients with RT planning MRIs obtained between 3-6 weeks after biopsy or surgical resection were included. RT target volumes were contoured and compared between post-operative and RT planning MRIs. Volumetric changes in GTV2 (surgical cavity + residual enhancing disease) and GTV1 (edema + GTV2) were calculated. Progression-free survival (PFS) and overall survival (OS) were measured.The mean time between post-operative and RT planning MRI was 29.4 days (range: 21-42 days). When comparing post-operative and RT planning MRIs, the mean decrease in GTV1 was 25.8cc or 14.7% (P = 0.011) and the mean increase in GTV2 was 10.21cc or 39.6% (P = 0.0013). GTV1 decreased at an average rate of 0.5% per day and GTV2 increased at an average rate of 1.4% per day. The proportional growth was similar to a rate of historical controls of mixed high-grade gliomas. Median PFS and OS in our group were 5.6 and 11.2 months, respectively. A delay of more than one month between post-operative and planning MRI was associated with worse median OS of 8.0 months compared with 11.5 months (P = 0.044).To our knowledge, this is the largest volumetric study of the impact of post-operative MRIs in a uniform group of IDH-wildtype GBM. RT planning MRIs performed 3-6 weeks after biopsy or surgical resection of IDH-wildtype GBM demonstrate significant volumetric changes. Similar to previously published data on a heterogenous population of high-grade gliomas, decreases in GTV1 signify a resolution of edema, however, increases in GTV2 imply recurrence or regrowth of disease over a relatively short time. While this was not statistically significant in a previously published analysis of a heterogeneous population of high-grade gliomas, our analysis of a homogeneous population of IDH-wildtype GBM demonstrates a statistically significant increase in GTV2. Delaying planning MRI more than one month post-operatively was associated with worse OS. These findings support the need for RT planning MRIs and confirm the association between delayed treatment and worse survival. Radiomic analysis of cavity regression vs. tumor regrowth is forthcoming.J.B. Bell: None. B.J. Rich: None. I.B. Mihaylov: Research Grant; Philips Radiation Oncology Systems, NIH.C. Benjamin: None. E.A. Mellon: None. M.C. Abramowitz: None. G. Azzam: None. M. Guillermo Prieto Ei: None. M. De La Fuente: None. M. Butkus: None. T. Diwanji: None.

Partial intracapsular tonsillectomy in the treatment of pediatric obstructive sleep apnea/hypopnea syndrome: a prospective study with 5-year follow-up.

ObjectiveTo assess efficacy and safety of tonsil reduction with bipolar forceps electrocautery as treatment of paediatric obstructive sleep apnea/hypopnea syndrome (OSAHS).Study designProspective interventional study.MethodsTwo hundred and sixty-three children aged 4–10 years with OSAHS and an apnea hypopnea index (AHI) > 3 were enrolled from March 2013 to January 2016. Pre-operative evaluation included oropharyngeal clinical examination with fiberoptic nasopharyngoscopy, OSA-18 questionnaire and overnight sleep study. All children were treated with adenoidectomy and tonsillotomy with bipolar forceps. OSA-18 questionnaire and overnight sleep study were performed 30 days after surgery.ResultsPre-operative average of the OSA-18 questionnaires was of 70.3 (SD = 9.7); 30-day post-operative score was 23.15 (SD = 8.2; p = 0.045). Pre-operative average Apnea Hypopnea Index (AHI) score was 9.41 (SD = 4.1); 30-day post-operative average of AHI score was of 1.75 (SD = 0.8; p = 0.012). Oxygen Desaturation Index (ODI) rate changed from 7.39 (SD = 4) to 1.34 (30-day post-operative) (SD = 4.7; p = 0.085). NADIR rate changed from 79% (SD = 6.32) to 90% (30-day post-operative) (SD = 5.18; p = 0.00012). Peri- and post-operative complications in our sample were mainly pain (average 75 doses of paracetamol), while bleeding did not occur (0%). All patients received a follow-up examination 5 years after surgery to evaluate tonsil size; at this time-point, a reduction in tonsil size from 3.6 (3–4; SD = 4.2) to 1.3 (1–2; SD = 5.5) was found, while tonsil regrowth was observed in five children (2%).ConclusionThis study showed that partial tonsillotomy with bipolar forceps electrocautery associated to adenoidectomy is an effective technique in treating OSAHS symptoms in children and ensures less complications in terms of hemorrhage, postoperative pain and infections compared to traditional adenotonsillectomy. The very low tonsillar regrowth rate reported in this study may support the routine use of this technique.

Features of seasonal growth of Arundo donax var. versicolor Mill. (Stokes) in the conditions of the M. M. Gryshko National Botanical Garden of the National Academy of Sciences of Ukraine

Purpose. To define of phenological and morphological features of A. donax var. versicolor growth during the introduction in the M. M. Gryshko National Botanical Garden of the National Academy of Sciences of Ukraine (NBG). &#x0D; Methods. The object of research was the plants of A. donax var. versicolor in the collection of ornamental grasses of the department of flower and ornamental plants of NBG. The plants were grown on a sunny experimental area during 2014–2020. Since under NBG conditions, A. donax var. versicolor did not enter the flowering phase, the beginning of the phases of spring regrowth, leaf unfolding, and the end of the growing season were recorded. Morphometric parameters and shoot-forming ability were investigated for 3–5 years of cultivation. &#x0D; Results. The beginning and duration of the phases of shoot spring regrowth and the unfolding of leaves of A. donax var. versicolor as well as their dependence on the sum of effective temperatures was established. Thus, spring regrowth begins with renewal buds on May 11 ± 5 days at the effective temperature sums of 226.6 ± 19.7 °С. The phase of leaf development in plants occurred on May 20 ± 7 days. The effective temperature sum at the beginning of this phase was 309.45 ± 11.66 °C. The productivity of shoot formation (1.6 ± 0.3 shoot per plant) under the conditions of introduction was determined. &#x0D; Conclusions. A. donax var. versicolor plants did not have a full cycle of seasonal development in the conditions of the NBG. Plants formed vegetative monocyclic shoots 240–260 cm tall. The duration of their vegetation was 182–189 days. The optimal period for the growth of the ground mass of plants fell on July-August. During this period, the leaves were quickly formed, the number of which was 28.8 ± 6.68 on the shoot. The correlation between the rate of accumulation of effective temperatures and the rate of regrowth of plant shoots was recorded.

Long-term results of ultrasound (US)-guided radiofrequency ablation (RFA) of benign thyroid nodules: State of the art and future perspectives–A systematic review

Radiofrequency-ablation (RFA) is one of the most widely used treatment in specialized thyroid centers but, due to the relatively recent introduction into clinical Practice, there are limited long-term follow-up studies. to review outcomes of RFA on solid nonfunctioning (or autonomous) thyroid nodules (TN) on a long-time period for assessing the results in term of efficacy, complications, and costs and to compare them to the current indications of RFA. A systematic review was performed using EMBASE and Medline library data. Between 2008 and 2021, seventeen studies evaluated RFA for the treatment of benign solid TN, with an at least 18 months of follow-up. Data extraction and quality assessment were performed by two endocrinologists according to PRISMA guidelines. The majority of the studies were retrospective study and reported 933 nodules, mostly solid. Baseline volume ranged between 6.1 ± 9.6 and 36.3 ± 59.8 mL. Local analgesia was used and the time duration of the treatment was between 5 ± 2 and 22.1 ± 10.9 minutes. The volume reduction rate at 12 months ranged from 67 to 75% for the nodule treated with a single Procedure and reached to 93.6 ± 9.7% for nodules treated with repeat ablations. The regrowth rate at 12 months ranged from 0 to 34%. All the studies consistently validated the long-term clinical efficacy and the substantial safety of RFA for the treatment of benign TNs. TA, however, is an operator-dependent technique and should be performed in centers with specific expertise with a rigorous selection of the nodules.

Cost Effectiveness of Watch and Wait Versus Resection in Rectal Cancer Patients with Complete Clinical Response to Neoadjuvant Chemoradiation

BackgroundWatch and wait (WW) protocols have gained increasing popularity for patients diagnosed with locally advanced rectal cancer and presumed complete clinical response after neoadjuvant chemoradiation. While studies have demonstrated comparable survival and recurrence rates between WW and radical surgery, the decision to undergo surgery has significant effects on patient quality of life. We sought to conduct a cost-effectiveness analysis comparing WW with abdominoperineal resection (APR) and low anterior resection (LAR) among patients with stage II/III rectal cancer.MethodsIn this comparative-effectiveness study, we built Markov microsimulation models to simulate disease progression, death, costs, and quality-adjusted life-years (QALYs) for WW or APR/LAR. We assessed cost effectiveness using the incremental cost-effectiveness ratio (ICER), with ICERs under $100,000/QALY considered cost effective. Probabilities of disease progression, death, and health utilities were extracted from published, peer-reviewed literature. We assessed costs from the payer perspective.ResultsWW dominated both LAR and APR at a willingness to pay (WTP) threshold of $100,000. Our model was most sensitive to rates of distant recurrence and regrowth after WW. Probabilistic sensitivity analysis demonstrated that WW was the dominant strategy over both APR and LAR over 100% of iterations across a range of WTP thresholds from $0–250,000.ConclusionsOur study suggests WW could reduce overall costs and increase effectiveness compared with either LAR or APR. Additional clinical research is needed to confirm the clinical efficacy and cost effectiveness of WW compared with surgery in rectal cancer.

Is the severity of initial sensitization to diphenylcyclopropenone in alopecia areata patients predictive of the final clinical response?

Immunotherapy by diphenylcyclopropenone (DPCP) is generally started with 2% DPCP sensitization, however in recent years studies have questioned the necessity of sensitization that may cause patients severe reactions and troubles at the onset of therapy. The purpose of the present study was to evaluate the association between the severity of initial reaction to 2% DPCP sensitization in AA patients and clinical response. In this retrospective study, 110 AA patients who continued therapy for at least 6months were enrolled. Hair loss and hair regrowth rates were calculated based on the Severity of Alopecia Tool (SALT) scoring system. Initial reaction to 2% DPCP sensitization after 2 weeks was graded as negative reaction (absence of any reaction), doubtful reaction (mild erythema, pruritus, and irritation for minutes after test), weak (erythema, mild edema, and scaling), and strong to extreme reaction (vesicles, bullae, ulcer, and discharge). The degrees of the initial reaction to 2% DPCP after 2 weeks were negative reaction 13 (11.81%), doubtful reaction 40 (36.36%), weak reaction 33 (30%), and strong to extreme reaction 24 (21.81%). Patients were divided into two groups: (A) patients with less than 12-month therapy (75 of 110), (B) patients with more than 12-month therapy (35 of 110). Initial reaction to 2% DPCP sensitization was not correlated with hair regrowth rate in either group (group A: Spearman's rho=0.194, p =0.095; group B: Spearman's rho=0.063 p =0.720). After 12-month treatment with DPCP, hair regrowth rate was significantly greater than 6-months therapy (group A: 17.03 ± 37.78, group B: 49.26 ± 36.34; p =0.003). The severity of hair loss at the onset of treatment was significantly associated with the response rate in both groups (p-value <0.002). Based on our results, it is the initial severity of the disease and not the initial reaction to 2% DPCP sensitization that predicts the clinical response to DPCP immunotherapy.

A randomized controlled trial on the plaque-removing efficacy of a low-abrasive air-polishing system to improve oral health care.

While air polishing with abrasive powders has been proved efficient for sub- and supragingival application, only few studies concerning the quality of supragingival biofilm removal using the low-abrasive erythritol powder (EP) exist. The aim of the present randomized controlled trial was to clinically compare the efficacy of supragingival air polishing using EP in comparison with the rubber cup method, and to juxtapose the corresponding biofilm regrowth rates. Thirty-two young adults, suspending oral hygiene for 48 hours, were enrolled in the present double-blind short-term investigation. Using a split-mouth design, tooth polishing was conducted by means of either air polishing or rubber cups with prophylaxis paste (control). While 16 participants received air polishing in the second and fourth quadrants (and rubber cup prophylaxis in the first and third ones), the reverse sequence was applied with the remaining 16 subjects. Biofilms were assessed using the modified Quigley-Hein index (QHI), and QHI sum scores achieved both prior to and immediately after the polishing procedure, as well as 24 hours later, were assessed using a two-way analysis of variance (ANOVA), followed by Tukey's HSD to test multiple pairwise comparisons. Both methods revealed a significant reduction of QHI scores (P < .001). Compared to the rubber cup method, air polishing resulted in significantly lower scores, both after tooth cleaning and after 24 hours (P < .001). Supragingival biofilm removal by means of air polishing combined with low-abrasive erythritol seems to be more efficacious than the traditional polishing method, and should improve oral health care.

Organ preservation following short-course radiotherapy for rectal cancer.

BackgroundNon-operative management of rectal cancer is increasingly being used in selected patients. Most reports include patients treated with chemoradiotherapy (CRT) before inclusion into a Watch & Wait (W&W) programme. The aim of this study was to report outcomes from a single-centre W&W programme involving a large cohort of patients.MethodsPatients treated with chemoradiotherapy (CRT) or short-course radiotherapy (SCRT) with or without chemotherapy, between 2008 and 2020, who showed signs of a clinical complete response (cCR) were reviewed. Patients were assessed using digital rectal examination, flexible endoscopy, carcinoembryonic antigen measurement, MRI, and CT imaging, discussed at the multidisciplinary tumour board meeting, and followed up in a dedicated W&W programme as from 2015. Outcomes including regrowth and 3-year survival (time to regrowth or death) were prospectively evaluated.ResultsOf 142 patients who were assessed, 88 fulfilled the criteria for cCR. Treatment before cCR included CRT, SCRT with chemotherapy, and SCRT alone in 16 (18 per cent), 28 (32 per cent), and 44 (50 per cent) patients, respectively. Patients treated with CRT and SCRT with chemotherapy had more advanced clinical T- and N-stage, compared with patients treated with SCRT alone (clinical T-stage > 2: 81 per cent and 89 per cent versus 47 per cent, respectively; clinical N-stage > 0: 75 per cent and 93 per cent versus 68 per cent, respectively). Overall rate of regrowth was 19 per cent, with 31 per cent, 21 per cent, and 14 per cent following CRT, SCRT with chemotherapy, and SCRT alone, respectively. Uni- and multivariable analyses evaluating the clinical parameters revealed no statistically significant associations with risk of local regrowth. All but one patient with regrowth underwent salvage surgery. The 3-year survival rate (death with regrowth as competing risk) was 93 per cent, with no significant difference between treatment groups.ConclusionIn this cohort of W&W patients, the vast majority received SCRT with or without chemotherapy and results consistent with previous W&W reports were obtained. No statistically significant differences in terms of regrowth rate were obtained when comparing CRT, SCRT with chemotherapy, and SCRT alone. SCRT can induce sustained cCR and may precede a W&W strategy.

Systemic therapy of onychomycosis of the feet with terbinafine: dynamics of nail rehabilitation and quality of life

BACKGROUND: Systemic therapy with terbinafine (Exifin) forms the basis of any treatment programs for onychomycosis of the feet of dermatomycete etiology. At the same time, the available literature presents relatively little data on the efficacy and safety of systemic terbinafine drugs for individual age groups; and there are practically no such studies based on a large statistical sample with a simultaneous assessment of the dynamics of the quality of life indicator. AIMS: To study the use of the drug Exifin tablets in certain age groups of patients with mycosis and onychomycosis in clinical practice. MATERIALS AND METHODS: The study was a multicenter observational (non-interventional) study involving 1602 patients with varying degrees of severity of onychomycosis of the feet/hands. The patients were divided into 4 age groups, each of which was divided into subgroups according to the severity of onychomycosis, from very mild to extremely severe. The positive dynamics of regression of symptoms, improvement of the quality of life according to the survey scale, the presence or absence of significant adverse reactions were evaluated. RESULTS: In all 1602 patients, positive dynamics from the skin process was obtained in the form of regression of onychomycosis symptoms. The best results on the speed of nail sanitization were obtained in more young age groups with a mild degree of onychomycosis. The lowest rate of regrowth of a healthy nail plate was observed in the age groups 4560 years and over 60 years. In the same age groups, the greatest number of persistent onychodystrophy remained after the eradication of the fungus. In all age groups, there was a positive trend in the quality of life: at the end of treatment, 67% of patients rated the quality of life as excellent and good, and another 24.1% ― satisfactory. No adverse events were recorded in any clinical case. CONCLUSION: Systemic therapy with terbinafine in onychomycosis of the feet/hands is a highly effective component in the combination treatment, allowing to achieve eradication of the fungus in 8590% of cases.

Antecedent Drought Condition Affects Responses of Plant Physiology and Growth to Drought and Post-drought Recovery

Antecedent environmental conditions may have a substantial impact on plant response to drought and recovery dynamics. Saplings of Eucalyptus camaldulensis were exposed to a range of long-term water deficit pre-treatments (antecedent conditions) designed to reduce carbon assimilation to approximately 50 (A50) and 10% (A10) of maximum photosynthesis of well-watered plants (A100). Thereafter, water was withheld from all plants to generate three different levels of water stress before re-watering. Our objective was to assess the role of antecedent water limitations in plant physiology and growth recovery from mild to severe drought stress. Antecedent water limitations led to increased soluble sugar content and depletion of starch in leaves of A50 and A10 trees, but there was no significant change in total non-structural carbohydrate concentration (NSC; soluble sugar and starch), relative to A100 plants. Following re-watering, A50 and A10 trees exhibited faster recovery of physiological processes (e.g., photosynthesis and stomatal conductance) than A100 plants. Nonetheless, trees exposed to the greatest water stress (−5.0 MPa) were slowest to fully recover photosynthesis (Amax) and stomatal conductance (gs). Moreover, post-drought recovery of photosynthesis was primarily limited by gs, but was facilitated by biochemistry (Vcmax and Jmax). During recovery, slow regrowth rates in A50 and A10 trees may result from insufficient carbon reserves as well as impaired hydraulic transport induced by the antecedent water limitations, which was dependent on the intensity of drought stress. Therefore, our findings suggest that antecedent water stress conditions, as well as drought severity, are important determinants of physiological recovery following drought release.