Subgroups A1 Research Articles

CLINICAL JUSTIFICATION OF THE EFFICIENCY OF USING IMPROVED METHODS OF DETERMINING AND FIXING OCCLUSAL RELATIONSHIPS IN PATIENTS WITH PARTIAL EDENTULOUS

Determining the optimal occlusal relationships according to the anatomical and functional features of the maxillofacial system (MFS) and subsequent adaptation till physiological functions are restored is an actual task during prosthetic treatment of patient with partial edentulous with help of fixed and removable partial denture (FPD, RPD). Purpose: to establish the effectiveness of the proposed methods of determining and fixing of the occlusal relationships based on the study of clinical indicators in patients who simultaneously use FPD and RPD for prosthetic therapy. Material and Methods. Our study included 120 patients aged 55-70 years with partial edentulous without endocrine and systemic disorders, acute forms of periodontal tissues diseases and good level of individual oral hygiene who came to the Department of Stomatology of Postgraduate Education of Ivano-Frankivsk National Medical University for prosthetic treatment. Prosthetic treatment was carried out with FPD, RPD using the proposed methods of forming occlusal relationships (group 1) and generally accepted methods (group 2). Each study group was divided into two subgroups: a – patients without occlusal disorders, and b – patients with occlusal disorders and vertical occlusion dimension (VOD) loss. The examination of each person included the collection of anamnesis and complaints, general dental examination, the determination of the Russell periodontal index (PI), the assessment of occlusal relationships and the condition of the temporomandibular joint (TMJ) according to "Hamburg protocol". Results and conclusions. The analysis of patient’s complaints and anamnesis, the data of the objective dental examination, and assessment of the periodontal tissue condition established the effectiveness of the proposed methods of determining and fixing occlusal relationships in patients with partial edentulous simultaneously treated with FPD and RPD. In addition, 23.3% more people of the 2a subgroup felt tension and fatigue of the masticatory muscles a week after treatment than in 1a subgroup, and 36.7% more - in the 2b subgroup than in 1b after a year of FPD and RPD use (p< 0,05). There were significantly more patients with signs of eccentric supraocclusion in the 2a subgroup a year after prosthetic treatment than in 1a (30±0.09% (9) and 3.3±0.03% (1)), and with signs of centric supraocclusion in the 2b subgroup - 36.7±0.09% (11), against 10±0.06% (6) in 1b (p <0.05). Also, there was observed a positive effect of proposed method of determining and fixing of the occlusal relationships during prosthetic treatment on TMJ a year after prosthetic treatment with FPD and RPD. There were 16.7% and 13.3% fewer people in 1a and 1b subgroups with one positive symptom of the “Hamburg protocol” and 6.7% and 40% fewer persons with two positive symptoms, compared to the data received before treatment. There was an increase by 13.3% of number of patients with one positive symptom according to “Hamburg protocol” in the 2a subgroup and by 10% of persons with two symptoms. It was determined a decrease of patients with two positive symptoms according to “Hamburg protocol” in 2b subgroup by 10% after one year. An improvement of periodontal tissues condition of abutment teeth was evaluated by PI assessment after a year of observation of patients. It was established that the average value of PI in subgroup 1b was significantly lower by 57.6% than in subgroup 2b, and it was lower in subgroup 1a by 39.3% than in patients of subgroup 2a (р<0,05).

Optimization of the Lens Nucleus Fragmentation Pattern During Hybrid Phacoemulsification with Different Cataract Densities

Purpose: comparative study of the energy and hydrodynamic parameters of phacoemulsification using different patterns of femtosecond laser fragmentation of the lens nucleus in patients with grade III and IV cataracts.Patients and methods. Femtosecond laser (hybrid) phacoemulsification was performed in 252 patients (252 eyes) with grade III cataracts (group 1), and 237 patients (237 eyes) with grade IV cataracts according to the Buratto classification (group 2). In subgroup 1A, the pizza pattern (10 radial incisions) was used for femtosecond laser fragmentation of the nucleus. In subgroup 1B — the cylinder pattern (a combination of 8 radial incisions with 5 circular incisions), and in subgroup 1C — the grid pattern (8 radial incisions in combination with multiple incisions in the central zone in the form of a grid with a cell of 0.5 mm). In subgroup 2A, the pizza pattern was used for femtosecond laser fragmentation of the nucleus, in subgroup 2B — the cylinder pattern, and in subgroup 2C — the mesh pattern. Anterior capsulorhexis and preliminary fragmentation of the lens nucleus were performed using the VICTUS femtosecond laser surgical system. The effective ultrasound time and volume of the irrigation solution consumed at the stage of emulsification of the nuclear fragments were calculated. Corneal endothelial cell loss was assessed in 3 months after the surgery.Results. In group 1, the shortest effective ultrasound time was revealed if the mesh pattern 1.65 ± 0.69 s, it was significantly less than the cylinder pattern — 2.33 ± 0.72 s (p < 0.05) and the pizza pattern — 3.18 ± 0.83 (p < 0.01). In group 2, the shortest effective ultrasound time was revealed when using the “grid” pattern 3.96 ± 0.81 s, it was significantly less than the “cylinders” pattern — 4.93 ± 0.93 s (p < 0.05) and the “pizza” pattern — 6.17 ± 1.13 s (p < 0.05). In group 1, the volume of irrigation solution consumed during emulsification of nuclear fragments was significantly less when using the “grid” pattern — 20.3 ± 3.0 ml compared to the “cylinders” patterns — 30.4 ± 5.6 (p < 0.05) and the “pizza” pattern 38.2 ± 7.8 ml (p < 0.01). In group 2, the volume of irrigation solution consumed during emulsification of nuclear fragments was significantly less when using the “mesh” pattern — 39.0 ± 7.9 ml compared to the “cylinder” patterns — 57.5 ± 10.0 ml (p < 0.05) and the “pizza” pattern — 77.0 ± 12.9 ml (p < 0.01). In group 1, after using the “mesh” pattern, the loss of corneal endothelial cells was 3.36 ± 0.93 %, which was significantly less compared to the “cylinder” pattern — 5.04 ± 1.21 % (p < 0.05) and the “pizza” pattern — 6.93 ± 1.53 % (p < 0.05). In group 2, after using the “grid” pattern, the loss of corneal endothelial cells was 8.61 ± 1.65 %, it is significantly less compared to the “cylinders” pattern — 9.83 ± 1.73 % (p < 0.05) and the “pizza” pattern — 11.52 ± 1.91% (p < 0.05).Conclusion. The “grid” pattern allows to minimize the effective ultrasound time, the volume of the spent irrigation solution and, as a consequence, the loss of corneal endothelial cells compared to other patterns of femtosecond laser fragmentation

About adverse events of targeted therapy for polypous rhinosinusitis

The study of biologically active inflammatory mediators is important in the diagnosis of allergic rhinitis. The aim of the present study was to evaluate the levels of secretory immunoglobulin A (sIgA) in nasal secretions in the upper respiratory tract allergies in patients living in various cities of the Russian Federation. Patients and methods. We examined 86 patients aged 28 to 40 years (men-to-women ratio was 1:1 in patients and control group) with a persistent form of allergic rhinitis living in various cities of Russian Federation (Chelyabinsk, Moscow). Group 1 included 36 patients with newly diagnosed allergic rhinitis who did not take any medications (subgroup 1a included 18 persons living in Chelyabinsk; 1b consisted of 18 patients living in Moscow). Group 2 included 30 patients who received long-term intranasal steroid medications (4.9±0.9 months): 2a, patients who lived in Chelyabinsk (n = 15), and 2b lived in Moscow (n = 15). Control group 3 included twenty healthy volunteers aged 28 to 40 years. The disease symptoms were documented in the patients, nasal secretions were collected by endoscopy, and the samples were analyzed by enzyme immunoassay (ELISA). It has been shown that the levels of secretory immunoglobulin A (sIgA) in nasal secretions showed a significant (p 0.05) unidirectional decrease in adult patients with allergic rhinitis living in various cities of the Russian Federation.

COMPARATIVE ANALYSIS OF THE SOLUBILITY OF MODIFIED CONVENTIONAL GLASS IONOMER CEMENT AND RESIN-MODIFIED GLASS IONOMER CEMENT IN ARTIFICIAL SALIVA WITH VARYING PH LEVELS

Objectives: To determine the solubility of modifi ed conventional glass ionomer cement and resin-modified glass ionomer cement in artificial saliva at varying pH levels.Materials and Methods: Two luting cements were used to fabricate 120 specimens, following ISO standard 4049/2000. The specimens were divided into two groups, Group A (conventional glass ionomer luting cement) and Group B (resin-modifi ed glass ionomer luting cement), each containing 60 specimens, and further sub divided into three subgroups A3,A7,A9,B3,B7 and B9. Solubility was assessed by measuring weight changes after immersion in artifi cial saliva with varying pH levels for 28 days. A one-way ANOVA was conducted to statistically assess the differences in mean solubility among the groups, with post hoc Tukey's test applied for multiple comparisons. Additionally, paired t-tests were used to compare results between groups based on the media used.Results: Mean solubility of specimens of subgroup A9 immersed in basic salivary solution showed least solubility among all the groups. The mean solubility of G1 & RMGI luting cement in artifi cial cement saliva having PH 3.7& 9 respectively.Conclusion: Conventional glass ionomer luting cement with modifi ed powder/liquid ratio is more reliable for luting of fixed prosthesis as it exhibited lowest solubility in basic and acidic conditions.

Comparative Analysis of Surface Roughness and Design Features of Titanium Dental Implants on Primary Stability and Osseointegration

ABSTRACT Objective: This study aimed to evaluate the impact of the surface roughness and design features of titanium dental implants on primary stability and osseointegration. Methods: Sixty titanium dental implants were categorized into three groups based on their surface roughness: smooth (Subgroup A1), moderately rough (Subgroup A2), and highly rough (Subgroup A3). Each roughness category was further divided into three design subgroups: cylindrical (B1), tapered (B2), and hybrid (B3). Primary stability was assessed using insertion torque and resonance frequency analysis (RFA). Osseointegration was evaluated through histological and histomorphometric analyses, measuring bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) at 4, 8, and 12 weeks post-implantation in rabbit models. Results: Highly rough-surface implants (Subgroup A3) demonstrated significantly higher insertion torque and ISQ values than smooth (Subgroup A1) and moderately rough (Subgroup A2) implants (P < 0.001). Among the design features, tapered implants (Subgroup B2) exhibited the highest insertion torque and ISQ values (P < 0.001). Histological and histomorphometric analyses revealed that highly rough-surface implants (Subgroup A3) and tapered implants (Subgroup B2) had the highest BIC and BAFO percentages at all time points (P < 0.001). Conclusion: These findings indicate that both surface roughness and implant design significantly influence primary stability and osseointegration.

Macrophage tracking with USPIO imaging and T2 mapping predicts immune rejection of transplanted stem cells

To develop a clinical imaging method for monitoring macrophage migration to the defect site after implantation of various stem cells and evaluating immune responses in the context of knee arthritis, T2 mapping was correlated with CD68-positive cell densities in defects and the bone marrow. This study, which was approved by the Institutional Animal Care and Use Committee, used 32 New Zealand white rabbits preloaded with ultrasmall superparamagnetic iron oxide particles (USPIOs). They were divided into groups that received different stem cell implants after osteochondral defect induction. T2 imaging was performed using a 3.0 T MR scanner, and the data were analysed via one-way ANOVA, with CD68 expression assessed via immunohistochemistry. After implantation, the T2 signal intensity increased across groups, with subgroup D1 (implantation of rat bone marrow stem cells (BMSCs)) showing the lowest T2 value early and the steepest increase in T2 values. Notable differences in CD68-positive cell density were found between Subgroup D1 and the other groups and between Subgroups A1 and C1 post-surgery. A moderate negative correlation was observed between T2 signals and CD68-positive cell density in defects (r = -0.468, p = 0.001), whereas a weak correlation was detected in the bone marrow (r = 0.096, p = 0.313). A significant link was identified between CD68-positive cell density in the bone marrow and in defects (r = -0.255, p = 0.001). This study revealed significant differences in immune responses to stem cells from different origin tissues in the context of cartilage repair. Adipose-derived stem cells (ADSCs) were found to be more likely to provoke immune rejection than were BMSCs in the repair of femoral condyle cartilage defects. Compared with allogeneic transplants, xenogeneic mesenchymal stem cell transplants were associated with prolonged immune rejection. T2 mapping technology was effective in predicting the density of CD68-positive cells, providing a valuable tool for immune monitoring in stem cell therapy.

Features of eyelid microcirculation in chronic mixed blepharitis and type 2 diabetes mellitus

BACKGROUND: Microcirculatory dysfunction in patients with diabetes mellitus leads to tissue trophic insufficiency, reduction of adaptation reserves. It is possible to perform lifetime assessment of structural and functional changes in the microcirculation system by laser Doppler flowmetry. The presence of microcirculatory disorders is established in eyelids in chronic blepharitis and meibomian gland dysfunction. The article presents the results of the study concerning the peculiarities of neoangiogenesis as a mechanism of development of chronic blepharitis and meibomian gland dysfunction in diabetes mellitus (DM).AIM: to reveal the peculiarities of microcirculatory disorders of the eyelid in chronic mixed blepharitis in patients with type 2 diabetes mellitus (T2DM).MATERIALS AND METHODS: The study was conducted in 57 patients: 37 patients with chronic mixed bilateral blepharitis and a verified diagnosis of T2DM (group 1, n=74 eyes, average age 69.5 ± 7.5 years; subgroup 1a, n=38 eyes — patients with T2DM and glycated hemoglobin average level (HbA1с) 6.7±1.2; subgroup 1b, n=36 eyes — patients with T2DM and HbA1с average level 8.2±1.3) and 20 patients with chronic mixed bilateral blepharitis without signs of DM (group 2, n=40 eyes, mean age 67.2±4.3 years). Laser Doppler flowmetry was performed on the device «LAZMA MC-1».RESULTS: In patients with chronic blepharitis against the background of T2DM the development of ischemia of the eyelid tissue with increasing tension of functioning of the regulatory systems of microcirculation blood flow and lymph flow was detected, and in persons without DM — venous stasis with moderate inhibition of vasomotor, respiratory and dominance of cardiac oscillations of blood flow, as well as insufficiency of neurogenic oscillations of lymph flow. In this case in 1a subgroup the dominance of neurogenic oscillations of blood flow was revealed, in 1b - myogenic. Microcirculatory changes of lymph flow in the 1b subgroup were more pronounced in comparison with the 1a subgroup.CONCLUSION: The results proves the negative influence of T2DM on the microcirculatory bed of patients with chronic mixed blepharitis. The disorders detected by laser Doppler flowmetry vary depending on the HbA1с.

Spectrophotometric Evaluation of the Color Stability of Nanofilled Composites With and Without a Dentin Bonding Agent as a Surface Sealer Following Exposure to Common Beverages.

The aim of this study is to evaluate the color stability of nanofilled composites with and without the application of a dentin bonding agent (Single Bond Universal Adhesive) as a surface sealer, following exposure to common beverages. Eighty specimen disks of a nanofilled composite (Filtek 350XT) were prepared and divided into two groups: one treated without a composite sealer (Group A) and one with a composite sealer (Single Bond Universal Adhesive) (Group B). Each group was subdivided into four subgroups (subgroups A1, A2, A3, and A4 and subgroups B1, B2, B3, and B4), and each subgroup was immersed in a separate container containing coffee, tea, cola, or distilled water for 15 days. Color changes (ΔE) were measured using a spectrophotometer at baseline and after 15 days. Statistical analysis was performed using one-way analysis of variance (ANOVA) followed by Tukey's honestly significant difference (HSD) test. Statistically significant differences in color stability were observed between the sealed and unsealed groups. Specimens without sealant (subgroups A1, A2, and A3) showed greater color changes compared to sealed specimens (subgroups B1, B2, and B3). Coffee caused the greatest color change (ΔE = 30.31 for A1 vs. 12.00 for B1), followed by tea and then cola. Control groups immersed in distilled water showed minimal color change, which was not statistically significant (p > 0.05). The results suggest that applying Single Bond Universal Adhesive as a composite sealer significantly reduces discoloration of nanofilled composites when immersed in coffee, tea, and cola over a 15-day in vitro period. Further research is needed to explore its long-term efficacy.

Identification of Defined Molecular Subgroups on the Basis of Immunohistochemical Analyses and Potential Therapeutic Vulnerabilities of Pulmonary Carcinoids

IntroductionMulti-omic studies have identified three molecular separated pulmonary carcinoid (PC) subgroups (A1, A2, B) with distinctive mRNA expression profiles (e.g., orthopedia homeobox protein [OTP]/achaete-scute homolog [ASCL1]/hepatocyte nuclear factor 1 homeobox A [HNF1A]). We aimed to establish an immunohistochemical (IHC) biomarker panel that enables subgroup identification, and assessment of its potential clinical relevance. MethodsAll patients with resected pulmonary carcinoids (2003–2012) were identified from the Dutch Cancer/Pathology Registry, and tumors were revised. The IHC expression of OTP/ASCL1/HNF1A was scored in a blinded fashion in a mRNA-profiled (n = 5/subgroup) and national carcinoid cohort (n = 478). The expression of potential therapeutic targets (somatostatin receptor type 2a [SSTR2A]/delta-like canonical Notch ligand 3 [DLL3]) was assessed. Immunohistochemistry was assessed using H-scoring. ResultsOTP/ASCL1/HNF1A reported similar IHC and mRNA expression patterns in the matched primary samples. In the national cohort, IHC separated PCs into subgroups A1 (n = 224 [53%], OTPhigh/ASCL1high/HNF1Alow), A2 (n = 161 [38%], OTPhigh/ASCL1low/HNF1Ahigh), and B (n = 37 [9%], OTPlow/ASCL1low/HNF1Ahigh). In 12% of PCs, no distinct classification could be provided. Patients with A1 were enriched for older age (83% > 50 y), female individuals (83%), and peripheral location (55%) with low SSTR2A (median = 10) and high DLL3 (median = 52) expression. A2 included younger patients (34% < 40 y) and endobronchial/central (87%) tumors with high SSTR2A (median = 160), but low DLL3 (median 0) expression. Group B included more male individuals (59%) and recurrence was more frequent (19%) than in groups A1 (8%) and A2 (6%). Neuroendocrine cell hyperplasia was enriched in A1 (25%) compared with A2 (3%) and B (0%). ConclusionsAn OTP/ASCL1/HNF1A IHC panel enables the identification of molecular-defined pulmonary carcinoid subgroups with distinct clinical phenotypes and diverging therapeutic vulnerabilities that require further prospective evaluation.

Treatment with medication for patients with psychosis within 2 days during waiting in the accident and emergency department and its correlation with length of in-patient stay: retrospective database study.

One of the 'critical goals' for psychiatric liaison services is reducing hospitalisation. Psychotropic medication is a treatment for psychosis, although research determining the efficacy of early medication administration is lacking. To determine whether commencing psychotropic medication within 2 days of psychiatric liaison input in the accident and emergency (A&E) department is correlated with length of in-patient psychiatric admissions for patients with psychosis. We gathered data on patients presenting to A&E sites covered by South London and Maudsley (SLaM) National Health Service Trust, who were subsequently admitted to and discharged from SLaM psychiatric in-patient wards with discharge diagnosis of psychosis between 2015 and 2020. The analysis set comprised 228 patients waiting in the A&E department under psychiatric liaison care for ≥2 days, of which 140 were started on medication within those 2 days (group A) and 88 were not (group B). Group A was divided into A1 (patients restarted on previous psychotropic medication taken within 1 week) and A2 (others, including those new to psychotropic medication or with past usage). Although Kaplan-Meier survival curves with log-rank tests demonstrated no statistically significant difference of in-patient admission duration between groups A and B or groups B1 and B2, further analysis revealed that subgroup A1 had statistically significant shorter admissions than group B (P = 0.05). Restarting patients with psychosis on medication they were taking within the week before A&E department attendance, within 2 days of arrival at the A&E department, is associated with statistically significant shorter admissions. The limitation is a relatively small sample size.

Investigating Cesarean Section Trends: A Study Using the Modified Robson Classification in a Tertiary Care Setting.

The cesarean section (CS) rate is steadily rising in developed and developing nations. While CS is often perceived as a life-saving intervention, it comes with associated dangers for both the presentand future pregnancies. The Robson criteria classify CS into 10 groups with further sub-divisions based on the gestational age, various pregnancy categories, prior obstetrical records, and the progress of labor and delivery. This retrospective record review was conducted at Aga Khan University Hospital in Karachi, Pakistan. A non-probability consecutive sampling method was employed to enroll all 1198 pregnant women who underwent CS delivery between July 1st and December 31st, 2022. A total of 2616 deliveries were performed during the study period; among these, 1198 (45%) were delivered by CS. Out of 10 groups of Robson Criteria, Group 5 emerged as the primary contributor to the overall CS rate, making up approximately 34.3% of cases, followed by Group 10, which contributed to28.5% of cases. Group 2 contributed 16.4% of cases in total, with subgroup 2A constituting 12% of the overall rates, and Group 1 was found to be the fourth contributing category (5.1%), succeeded by Group 6 (4.9%), Group 4 (3.9%), and Group 8 (3.4%). The Modified Robson Criteria was foundto be an effective and easy-to-comprehend tool, which assists in monitoring the indications of CS and aids in devising strategies to reduce itsrates in clinical practice.

Large rupture strain cotton ropes hybridized with affordable fiberglass chopped strand mat sheets for enhanced compressive behavior of reinforced concrete columns

The hybrid confinement system combines various fiber types within a single matrix, allowing for the adjustment of volumetric ratios to optimize confinement performance. Synthetic FRPs are more expensive and have a higher carbon footprint due to significant CO2 emissions during production. In response, this study presents an innovative hybrid confinement approach using two natural materials: cotton ropes and FSMS (CFS) to improve concrete strength and ductility. Specimens, standardized at 300 mm height and 150 mm diameter with longitudinal steel bars and stirrups, were divided into two groups based on CFS configurations. The stress-strain response of CFS-confined concrete displayed distinctive behavior: an initial parabolic phase leading to peak compressive stress (ultimate strength), followed by a linearly degrading phase. Across all subgroups, CFS confinement significantly enhanced ultimate strength and corresponding compressive strains, with Subgroup 2A achieving the highest improvements of 246 % in ultimate strength and 1477 % in strain. Moreover, the ductility gain was reported as high as 20 for CFS-confined concrete. A non-proportional enhancement in the compressive behavior was observed with the increase in confinement ratio. Predictive models were developed for the idealized two-branch response of CFS-confined concrete, encompassing expressions based on nonlinear regression for ultimate strength, corresponding strain, ultimate strain, and elastic modulus. Two existing models were modified to trach each branch of the response. Integrating these two adjusted models closely replicated the experimental compressive curves.

Dynamics of endothelial function in patients with arterial hypertension with different cardiovascular risk against the background of antihypertensive therapy

The aim of the work was to investigate the dynamics of endothelial markers in patients with arterial hypertension with different cardiovascular risk under the influence of the prescribed treatment during a year of observation. The first group (with a moderate risk of cardiovascular events) included 48 patients with arterial hypertension (AH). The second group consisted of 54 patients with hypertension and a high risk of cardiovascular events, namely type 2 diabetes. Each group of patients was randomized into two subgroups by blood pressure (BP) medication. In patients of subgroup 1a (n=29) and subgroup 2a (n=35) – the main subgroups – the therapy necessarily included the angiotensin II receptor antagonist losartan potas­sium in a dosage of 50-150 mg/day, depending on the blood pressure level. Patients of subgroup 1b (n=19) and subgroup 2b (n=19) – comparison subgroups were treated with antihypertensive drugs of other first-line groups according to the data of the unified clinical protocol for the treatment of hypertension. According to the ROC analysis, it was determined that the dynamics of endothelin-1 (ET-1) indicators after 9 and 12 months of therapy (a decrease of 12% or more from the initial level) can predict the normalization of indicators of the coagulation and anticoagulation systems with indicators of sensitivity and specificity – 85% (95% CI 62.1-96.6%) and 92.9% (95% CI 76.5-98.9%), respectively. A decrease in the level of Willebrand factor (fV) by 23% or more due to such a treatment time can be used as a prognostic sign in determining the regression of endothelial dysfunction with sensitivity – 75% (95% CI 50.9-91.2%), specificity – 100% (95% CI 87.5-100%). According to the given data, both in the group with moderate and with high cardiovascular risk, there is a relationship between endothelial dysfunction (ED) and the duration of hypertension, indicators of the lipid spectrum and abdominal obesity – factors that increase the viscous resistance of the blood circulation, as well as platelet hyperactivity in the bloodstream. We have also established that according to the dynamics of ET-1 indicators after 9 and 12 months of therapy (decrease by 27% or more from the initial level), it is possible to predict the normalization of indicators of the coagulation and anticoagulation systems with indicators of sensitivity – 81.8% (95% CI 59.7-94.7%), specificity – 90.6% (95% CI 75-97.9%). A decrease in the level of fV by 24.5% or more after a year of treatment can be used as a prognostic sign in determining the regression of endothelial dysfunction with sensitivity – 68.2% (95% CI 45.1-86.1%), specificity – 71.9% (95% CI 53.3-86.2%). The obtained results testify to the dominant role of type 2 diabetes as a factor in platelet disorders of hemostasis. Taking into account the positive dynamics of the above-mentioned markers of ED during the year of treatment, their relationship with the reduction of blood pressure, indicators of the lipid spectrum and abdominal obesity, it should be noted the positive effect of angiotensin II receptor blockers (BRA II) as endothelioprotective drugs. Considering the irrefutable literary data about the absence of thrombomodulin in the blood stream, even its insignificant appearance indicates the presence of endothelial dysfunction. Determining the state and dynamics of changes in endothelial function under the influence of prescribed therapy will make it possible to improve the diagnosis of endothelial function disorders and increase the effectiveness of treatment of patients with hypertension and various cardiovascular risks.

Subtyping of pancreatic neuroendocrine tumors by transcription factors, hormones, histology, and patient outcome.

Pancreatic neuroendocrine tumors (PanNETs) show pronounced heterogeneity in terms of hormone and transcription factor (TF) expression. TFs such as ARX and PDX1 are related to alpha- and beta-cell-type features, respectively, and partly associate with patient outcome. However, detailed studies correlating hormone expression, histology, and clinical data are lacking. The aim of this study was to identify subtypes of PanNETs that associate with histological, hormonal, and prognostic findings. Atotal of 185resected PanNETs were divided into five subtypes (types A1, A2, B, C, and D) by cluster analysis based on expression of four TFs (ARX, PDX1, ISL1, and CDX2) and correlated to the expression of hormones and DAXX/ATRX as well as ALT activation status, histology, and progression-free survival. Subgroup A1 (ISL1+/ARX+/PDX-/CDX2-) was most frequent (46%), followed by typeB (18%; ISL1+/ARX-/PDX+/CDX2-), A2 (15%; ISL1+/ARX+/PDX+/CDX2-), C(15%; ISL1-/ARX-/PDX-/CDX2-), and D(5%; ISL1-/ARX-/PDX+/CDX2+). Subgroups A1 and A2 showed astrong association with atrabecular growth pattern and glucagon and pancreatic polypeptide (PP) expression (p < 0.001), while A2 was in addition associated with gastrin expression. SubgroupB was associated with insulin production (p < 0.001) and included all 17insulinomas. SubgroupC was associated with solid morphology and expression of serotonin, calcitonin, and adrenocorticotropic hormone (ACTH). SubgroupD showed solid morphology, expression of ACTH, somatostatin, or serotonin and had the shortest disease-free survival (p < 0.01). ALT positivity was associated with poorer outcome in types A1 and A2 but not in other types. PanNETs can be categorized into five subgroups based on different TF signatures, which associate strongly with histology, hormone production, functionality, and patient outcome.

Comparative evaluation of the effect of three different obturation techniques on push-out bond strength of AH Plus Bioceramic and EndoCeramic sealers: An in vitro study.

Effect of three different obturation techniques on bond strength of bioceramic sealers. This study aimed to investigate the effect of cold lateral compaction, thermafil, and thermoplasticized obturation techniques on the push-out bond strength of AH Plus Bioceramic and EndoCeramic sealers. The design of the study was an in vitro study. Forty-two extracted teeth that were single-rooted and had fully developed apices were chosen, decoronated, and biomechanically prepared using rotary nickel-titanium (NiTi) instruments. Samples were divided into two groups of n = 21. Group 1: AH Plus Bioceramic sealer, Group 2: EndoCeramic sealer. Then, based on the obturation technique employed, each group was divided into three subgroups (n = 7): subgroups 1a, 2a: Cold lateral compaction; Subgroups 1b, 2b: Thermafil; and Subgroups 1c, 2c: Thermoplasticized (obtura). Using universal testing machine, slices from the middle third of the sample's root were analyzed to determine the push-out bond strength values. Compared to other groups push-out bond strength was noticeably higher for the cold lateral compaction technique with EndoCeramic sealer (Subgroup 2a), followed by the Thermafil technique with EndoCeramic sealer (Subgroup 2b). In the present study, compared to heat-based obturation techniques, cold lateral compaction showed better push-out bond strength values for both sealers. EndoCeramic sealer resulted in greater push-out bond strength values than AH Plus Bioceramic sealer.

Evaluation of Microleakage and Shear Bond Strength of Two Different Calcium-based Silicate Indirect Pulp Capping Agents When Restored with Glass Ionomer Cement and Composite Resin Restoration: A Comparative In Vitro Study.

Indirect pulp therapy (IPT) is a conservative treatment approach that leaves the deepest caries adjacent to the pulp undisturbed in an effort to avoid pulp exposure. The result of IPT is primarily dependent on the biocompatibility, sealing capacity, adaptability of the overlying restoration to underlying dentin, and strength of the liner material utilized. To evaluate shear bond strength (SBS) and microleakage of mineral trioxide aggregate (e-MTA) and biodentine when restored with glass ionomer cement (GIC) and composite resin after their initial set time. Around 40 extracted caries-free permanent molars were randomly divided into two groups according to the liner material used (group I (e-MTA) and group II-biodentine). Each group was further divided into subgroups A1, A2, B1, and B2, where A1 and B1 received GIC and A2 and B2 received composite resin restoration after the initial set time. Half of the samples from each subgroup were allotted to two test groups of SBS and microleakage evaluation. The SBS was evaluated using a universal testing machine, and microleakage was assessed using a dye penetration test. One-way analysis of variance (ANOVA) was used for intergroup comparison, and the paired sample t-test was used for intragroup comparison. Categorical data were analyzed using a nonparametric test at the 5% level of significance using Statistical Package for the Social Sciences (SPSS) version 21 for Windows. A statistically significant difference (p = 0.001) was found in SBS between the group (e-MTA) + composite and biodentine + composite, where the latter group showed the highest SBS. Microleakage was highest in the group (e-MTA) + GIC (0.6 ± 0.894) and lowest in the group biodentine + composite (0.2 ± 0.447). However, no statistically significant difference was found in microleakage among all four groups. Within the constraints of this study, biodentine can be suggested as the pulp capping agent to be restored with composite resin restoration after its initial set time. Patel C, Patel M, Panchal M, et al. Evaluation of Microleakage and Shear Bond Strength of Two Different Calcium-based Silicate Indirect Pulp Capping Agents When Restored with Glass Ionomer Cement and Composite Resin Restoration: A Comparative In Vitro Study. Int J Clin Pediatr Dent 2024;17(9):1035-1040.

Characterization of Escherichia coli Isolates in Recreational Waters: Implications for Public Health and One Health Approach

Escherichia coli is commonly found in the gastrointestinal tract of warm-blooded animals and is routinely used as an indicator of fecal contamination in recreational waters. While most E. coli are commensal, some can harbor pathogenic potential, posing a major public health risk. This study investigated the sources of fecal contamination in recreational waters through the characterization of E. coli isolates. Presumptive E. coli detection was performed using selective and differential media, confirmed by PCR, and followed by characterization. E. coli were detected in all studied aquatic environments, with most isolates belonging to phylogenetic groups D1 (24%, non-human mammals) and B1 (20%, birds), suggesting animals as primary contaminants sources. Among E. coli isolates, 35% were identified as diarrheagenic E. coli (DEC), with enterotoxigenic (34%) and enterohemorrhagic (26%) being the most prevalent pathotypes. Furthermore, 85% of all isolates and 86.5% of DEC isolates exhibited multi-drug resistance, with highest rates displayed in phylogenetic subgroups A1 (human and non-human mammals) and B1. This study highlights the importance of the One Health approach encompassing a human, animal, and environmental holistic health perspective to effectively manage public health strategies and ensure the safety of beachgoers.

Analysis of the course and outcomes of COVID-19 at different stages of the pandemic in hemodialysis patients

The purpose of this study was a comparative analysis of the characteristics of the course and outcomes of COVID-19 in HD patients at different stages of the pandemic, focusing on the of the use of immunomodulatory therapy.Materials and methods. The retrospective study included 897 HD patients with COVID-19 (mean age 60.7 years, M 58.5%) who were hospitalized at Moscow City Hospital № 52. Group 1 (n=720) consisted of patients infected between the end of March 2020 and April 2021, group 2 (n=177) included patients hospitalized in May-December 2021. Each of group was divided into 2 subgroups based on treatment approaches. Subgroup 1a (n=231) included patients of the initial period of the pandemic who did not receive adequate immunomodulatory therapy, while Subgroup 1b (n=489) included patients of the late stage, were treated with IL-6 receptor blockers and corticosteroids. In group 2, 108 patients in Subgroup 2a received similar therapy, while 69 patients in Subgroup 2b were treated with neutralizing monoclonal antibodies in the early stages of the disease.Results. Mortality rates in Group 1 and Group 2 was 20.1% and 14.7%, respectively (p&lt;0.09). The incidence of unfavorable outcome was highest in Subgroup 1a and lowest in Subgroup 2b (31.2% vs 5.8%, p&lt;0.01). Mortality in Subgroups 1b and 2a was comparable (14.9% and 20.4%), despite more severe initial lung damage according to CT data in Subgroup 2a. In these patients, immunomodulators was more frequently combined with therapeutic plasma exchange (TPE). Independent risk factors for an unfavorable outcome were the progression of pulmonary pathology, with the transformation of stages CT 1-2 to CT 3-4, and a high comorbidity index.Conclusions. The use of immunomodulatory drugs imprtoved the effectiveness of COVID-19 treatment in patients with CKD5D. In severe cases, the most favorable outcomes were achieved with a combination of immunobiological drugs, corticosteroids, and TPE. An even more significant reduction in mortality was observed following the introduction of neutralizing monoclonal antibodies into clinical practice. Independent predictors of unfavorable outcome of COVID-19 in HD patients were a high comorbidity index and the progression of CT 1-2 into CT 3-4.

Efficiency of dry versus wet Er,Cr:YSGG laser debonding of lithium disilicate veneers using different power outputs

Since water is the chromophore for the erbium, chromium-yttrium scandium gallium garnet (Er,Cr:YSGG) laser, the laser energy reaching the restoration decreases as part of it is absorbed by water. Theoretically, reducing the water or implementing dry debonding could reduce the energy consumed by water, increasing laser efficiency. Studies on whether it is suitable for removing veneers without using coolant are lacking. The purpose of this in vitro study was to evaluate the debonding time, intrapulpal temperature, and translucency of veneers during wet versus dry debonding with an Er,Cr:YSGG laser using different power outputs. Sixty-three maxillary central incisors were flattened labially to receive ceramic specimens. After cementation, ceramic specimens were irradiated with an Er,Cr:YSGG laser for debonding with different power outputs and water percentages (N=70): subgroup A1, 4W and 1% water; A20, 4W and 20% water; A40, 4W and 40% water; B1, 5W and 1% water; B20, 5W and 20% water; B40, 5W and 40% water; C1, 6W and 1% water; C20, 6W and 20% water; C40, 6W and 40% water, and a control group of unbonded ceramic specimens. During debonding, the temperature rise and debonding time were evaluated, followed by the evaluation of the translucency and surface topography of the debonded specimens. Two-way analysis of variance (ANOVA) and the Dunnett test were used to analyze the data (α=.05). The mean intrapulpal temperature rise varied significantly among groups B and C (P<.001), with the highest mean temperature rise found in subgroup B1 (4.00 ±0.00 ºC) and the lowest mean temperature rise in subgroup C20 (1.20 ±0.45 ºC). For the debonding time, the mean values of time required for debonding varied significantly among different groups (P<.001), with the longest time recorded in subgroup A1 (333.4 ±74.8s) and the shortest time recorded in subgroup C20 (17.0 ±6.0s). Only subgroups C1 (18.89 ±0.2) and C40 (18.60 ±0.2) showed a significantly lower translucency than the control group (19.44 ±0.06) (P<.001). Dry Er,Cr:YSGG laser debonding resulted in increased intrapulpal temperature when using high power outputs, but without exceeding the critical threshold of dental pulp temperature. Dry debonding also limited the transmission of laser energy, affecting the debonding efficiency. A power output of 5W and 20% water can be considered efficient and safe laser parameters for debonding lithium disilicate veneers if their reuse is intended.

ARX, PDX1, ISL1, and CDX2 Expression Distinguishes 5 Subgroups of Pancreatic Neuroendocrine Tumors With Correlations to Histology, Hormone Expression, and Outcome

Many pancreatic neuroendocrine tumors (PanNETs) fall into 2 major prognostic subtypes based on DAXX/ATRX-induced alternative lengthening of telomerase phenotype and alpha- and beta-cell-like epigenomic profiles. However, these PanNETs are still flanked by other PanNETs that do not fit into either subtype. Furthermore, despite advanced genotyping, PanNETs are generally not well-characterized in terms of their histologic and hormonal phenotypes. We aimed to identify new subgroups of PanNETs by extending the currently used transcription factor signatures and investigating their correlation with histologic, hormonal, molecular, and prognostic findings. One hundred eighty-five PanNETs (nonfunctioning 165 and functioning 20), resected between 1996 and 2023, were classified into 5 subgroups (A1, A2, B, C, and D) by cluster analysis based on ARX, PDX1, islet-1 (ISL1), and CDX2 expressions and correlated with trabecular vs solid histology, expression of insulin, glucagon, polypeptide (PP), somatostatin, serotonin, gastrin, calcitonin, adrenocorticotropic hormone (ACTH), DAXX/ATRX, MEN1, and alternative lengthening of telomerase status by fluorescence in situ hybridization, and disease-free survival. A1 (46%, ARX+/ISL1+/PDX1−/CDX2−) and A2 (15%, ARX+/ISL1+/PDX1+/CDX2−) showed trabecular histology and glucagon/PP expression, with A2 also showing gastrin expression. B (18%, PDX1+/ISL1+/ARX−/CDX2−) showed solid histology, insulin, and somatostatin expression (P < .001). It included all insulinomas and had the best outcome (P < .01). C (15%, ARX−/PDX1−/ISL1−/CDX2−) showed solid histology and frequent expression of serotonin, calcitonin, and ACTH. D (5%, PDX1+/CDX2+/ISL1−/ARX−) showed solid histology, expressed ACTH/serotonin, and was an independent poor prognosticator (P < .01). Differential expressions of ARX, PDX1, ISL1, and CDX2 stratified PanNETs into 5 subgroups with different histologies, hormone expressions, and outcomes. Subgroups A1 and A2 resembled the alpha-cell-like type, and subgroup B, the beta-cell-like type. Subgroup C with almost no transcription factor signature was unclear in cell lineage, whereas the PDX+/CDX2+ signature of subgroup D suggested a pancreatic/intestinal cell lineage. Assigning PanNETs to the subgroups may help establish the diagnosis, predict the outcome, and guide the treatment.