Κυριακή 26 Ιουνίου 2022

Nanobots to eliminate bacteria in root canals – Nano Dentistry

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Nanobots in Root Canal Treatment

With millions of Root Canal Treatments being performed every day across the globe, it is important to make sure that Root Canal Treatment is successful in clearing out the bacteria form the Root canals to achieve the purpose of saving an infected tooth using root canal treatment. Disinfection protocol being used today includes mechanical preparation along with use of chemicals such as Sodium Hypochlorite, Hydrogen Peroxide, Chlorhexidine, etc along with Lasers a nd Ultrasonic devices. If these chemicals fail to penetrate the dentinal tubules, accessory canals, etc, proper disinfection cannot be achieved. This is where Nanobots have come into action in eliminating Bacteria in Root Canals which is being termed as - "Nano Dentistry" According to American association of endodontics over 25 millions of root canals are performed annually, over 90% are successful, remaining 10% failures are due to inadequate decontamination of root canal treatment. The dentinal tubules are very small, and the bacteria reside deep in the tissue. correct techniques are not efficient enough to go all the way inside and kill the bacteria. To address these treatment failures, researchers from the "Indian institute of science and nano robotics" company "Theranautilus"  have demonstrated that nano sized robots (nanobots) can effectively kill bacteria in the dentinal tubules. [caption id="attachment_6922" align="alignnone" width="549"]
Nanobots in Root Canal Treatment

Source - https://www.indiatoday.in/science/story/tiny-nanobots-in-teeth-can-kill-bacteria-help-better-dental-treatment-1950064-2022-05-16[/caption] How do Dental Nanobots work in Root Canal Treatment?  Dental Nanobots work by heating up their surface and in turn killing the bacteria in the canals with which they come in contact. So Nanobots use heat to disinfect the canals without the need for chemicals. According to the findings, nanobots were able to penetrate up to 2000um into dentinal tubules, thus achieving a vast improvement in penetration depth compared to laser activation and ultrasonic devices, researchers believe that using the heat to kill the bacteria is the safe alternative to using harsh chemicals agents or antibiotics to decontaminate a root canal. When the nanobots were injected into extracted tooth samples, the nanobots are penetrated deep inside the the dentinal tubules under the control of device that generates a low intensity magnetic field. By manipulating magnetic field, the researches were able to cause the surface of nanobots to generate heat to kill the bacteria nearby. To this end, researchers are currently developing a novel medical device that can be easily placed inside the patient mouth and allow the dentist to inject and manipulate the nanobots inside the teeth during the root canal therapy. Nanobots Or magnetically controlled nanoparticles have been used to trap and move objects using light, which pass through blood and tend to adhere to cancer cells. Researchers at Theranautilus, have used the dental nanoparticles on mice and have concluded them to be safe for use in Biological tissue. The study, titled "Mobile nanobots for prevention of root canal treatment failure", was published online on 28 April 2022 in Advanced Healthcare Materials, ahead of inclusion in an issue. References - Researchers use nanobots to eliminate bacteria in Root canals - Dental Tribune
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Differential perivascular microglial activation in the deep white matter in vascular dementia developed post‐stroke

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Differential perivascular microglial activation in the deep white matter in vascular dementia developed post-stroke

Post-stroke patients who develop dementia accrued more perivascular activated CD68+ microglia in the frontal white matter (FWM) This implies activated CD68+ cells are responsible for perivascular inflammation within the gliovascular unit of the FWM


Abstract

With the hypothesis that perivascular microglia are involved as neuroinflammatory components of the gliovascular unit contributing to white matter hyperintensities on MRI and pathophysiology, we assessed their status in stroke survivors who develop dementia. Immunohistochemical and immunofluorescent methods were used to assess the distribution and quantification of total and perivascular microglial cell densities in 68 brains focusing on the frontal lobe WM and overlying neocortex in post-stroke dementia (PSD), post-stroke non-dementia (PSND) and similar age control subjects. We primarily used CD68 as a marker of phagocytic microglia, as well as other markers of microglia including Iba-1 and TMEM119, and the myeloid cell marker TREM2 to assess dementia-specific changes. We first noted greater total densities of CD68+ and TREM2+ cells per mm2 in the frontal WM compared to the overlying cortex across the stroke cases and controls (p =&nbs p;0.001). PSD subjects showed increased percentage of activated perivascular CD68+ cells distinct from ramified or primed microglia in the WM (p < 0.05). However, there was no apparent change in perivascular TREM2+ cells. Total densities of TREM2+ cells were only ~10% of CD68+ cells but there was high degree of overlap (>70%) between them in both the WM and the cortex. CD68 and Iba-1 or CD68 and TMEM119 markers were colocalised by ~55%. Within the deep WM, ~30% of CD68+ cells were co-localised with fragments of degraded myelin basic protein. Among fragmented CD68+ cells in adjacent WM of PSD subjects, >80% of the cells expressed cleaved caspase-3. Our observations suggest although the overall repertoire of perivascular microglial cells is not changed in the parenchyma, PSD subjects accrue more perivascular-activated CD68+ microglia rather than TREM2+ cells. This implies there is a subset of CD68+ cells, which are respon sible for the differential response in perivascular inflammation within the gliovascular unit of the deep WM.

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Comparative effectiveness and stage‐shift effect of endoscopic exam among newly diagnosed oral cancer patients with different stages in Taiwan

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Abstract

Background

Patients with oral cancer are at higher risk of developing second primary esophageal cancer (SPEC) and the consensus for screening strategies remains unclear. This study aimed to examine comparative effectiveness and the stage-shift effect of endoscopic exam among patients with oral cancer.

Method

A population-based longitudinal retrospective observational matched case and control cohort study with at least 5 years follow-up was conducted. We identified 45 457 newly diagnosed patients with oral cancer, 2004–2013, and the eligible patient with oral cancer was 39 401. Propensity score matching was used to match comparable groups, and the two groups (screening vs. nonscreening) was 5941, individually. The study primary endpoints were to compare detection of incident SPEC and the stage-shift effect of endoscopic screening between screened and nonscreened incident oral cancer patients. Cox proportional hazard and competing risk models were analyzed. Statistical analyses were conducted in 2020–2021.

Result

Detection of incident SPEC in the screened group was significantly higher than in the nonscreened group (hazard ratio: 2.92, 95% confidence interval [CI]: 2.29–3.72). The stage-shift effect from endoscopic screening was found overall in patients with oral cancer (odds ratio [OR]: 0.39, 95%CI: 0.21–0.70), in particular in advanced-stage patients (OR: 0.25, 95%CI: 0.11–0.61), but not in early-stage patients (OR: 0.60, 95%CI: 0.26–1.40).

Conclusion

This study confirmed that endoscopic screening achieved early detection of SPEC among patients with oral cancer. To improve the screening stage-shift effect, patients with oral cancer are encouraged to undergo routine endoscopic screening.

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Kidney transplant from hepatitis C viremic donors into aviremic recipients and risk for post‐transplant BK and CMV infection

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Abstract

Background

kidney transplantation from HCV-viremic donors to uninfected recipients is associated with excellent short-term outcomes. However, HCV viremia might be associated with an increased risk for post-transplant viral complications.

Methods

We designed a retrospective study of HCV-negative kidney-only transplant recipients between 2018 and 2020. Recipients were grouped into group 1; HCV-negative donors, and group 2; HCV-viremic donors. Patients were matched 1:1 using propensity score. Primary objectives were to compare the incidence of CMV viremia ≥ 200 ml/IU, and BK viremia ≥1000 copies/ml between the groups. Secondary outcomes included group comparison of CMV disease, BK viremia ≥10,000 copies/ml, and one year patient and allograft survival.

Results

The study included 634 patients in group 1, and 71 patients in group 2. 65 pairs of patients were matched. Incidence of CMV viremia (33.3% vs 40.0%, p = 0.4675), and BK viremia (15.9% vs 27.7%, P = 0.1353) did not differ significantly between groups in the matched cohort. Incidence of CMV disease (81.0% Vs 76.9%; p = 1.000), and BK viremia ≥10,000 copies/ml (9.5% vs 16.9%, p = 0.2987) were comparable between groups. There was no difference in the one-year patient or allograft survival between groups.

Conclusion

kidney transplant from HCV-viremic donors is not associated with increased risk for BK or CMV viremia.

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Παρασκευή 24 Ιουνίου 2022

Tone Enhancement Electro‐Fiberscope Combined with Strobe Light Source and Re‐analysis Past Images‐Tone Enhancement Dynamic Stroboscope

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Tone Enhancement Electro-Fiberscope Combined with Strobe Light Source and Re-analysis Past Images-Tone Enhancement Dynamic Stroboscope

Tone enhancement electro fiberscope combined with strobe light source is benefit for dynamic observation of vocal fold vibration, mucosal waves and voice, it also may be effective for early detection of cases of glottal cancer rather than ordinate stroboscopic examination or simple NBI observation. Laryngoscope, 2022


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Prognostic Utility of Tumor Stage versus American Thyroid Association Risk Class in Thyroid Cancer

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Prognostic Utility of Tumor Stage versus American Thyroid Association Risk Class in Thyroid Cancer

The prognostic strengths of American Joint Committee on Cancer (AJCC) staging and American Thyroid Association (ATA) risk classification in well-differentiated thyroid cancer were evaluated. AJCC staging served as a more prognostic model for patient survival compared to ATA risk classification. The greater predictive strength of AJCC staging became less pronounced when multiple additional demographic and clinical factors were considered.


Objective

To evaluate the prognostic strengths of American Joint Committee on Cancer (AJCC) staging and American Thyroid Association (ATA) risk classification in well-differentiated thyroid cancer (DTC), and their implications in guiding medical decision-making and epidemiological study designs.

Methods

The 2004–2017 National Cancer Database was queried for DTC patients. Cox proportional hazards (CPH) and Kaplan–Meier analyses modeled patient mortality and overall survival, respectively. Each CPH model was evaluated by its concordance index, measure of explained randomness (MER), Akaike information criterion (AIC), and area under receiver operating characteristic curve (AUC).

Results

Overall, 134,226 patients were analyzed, with an average age of 48.1 ± 15.1 years (76.9% female). Univariate CPH models using AJCC staging demonstrated higher concordance indices, MERs, and AUCs than those using ATA risk classification (all p < 0.001). Multivariable CPH models using AJCC staging demonstrated higher concordance indices (p = 0.049), MERs (p = 0.046), and AUCs (p = 0.002) than those using ATA risk classification. The AICs of multivariable AJCC staging and ATA risk models were 7.564 × 104 and 7.603 × 104, respectively. AJCC stage I tumors were associated with greater overall survival than those classified as ATA low risk, whereas AJCC stages II-III and stage IV tumors demonstrated worse survival than ATA intermediate- and high-risk tumors, respectively (all p < 0.001).

Conclusion

AJCC staging may be a more predictive system for patient survival than ATA risk. The prognostic utility of these two systems converges when additional demographic and clinical factors are considered. AJCC staging was found to classify patients across a wider range of survival patterns than the ATA risk stratification system.

Level of Evidence

4 Laryngoscope, 2022

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Changes in Cough Airflow and Acoustics After Injection Laryngoplasty

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Changes in Cough Airflow and Acoustics After Injection Laryngoplasty

We explored the following hypotheses in a cohort of patients undergoing injection laryngoplasty: (1) glottic insufficiency affects voluntary cough airflow dynamics and restoring glottic competence may improve parameters of cough strength, (2) cough strength can be inferred from cough acoustic signal, and (3) glottic competence changes cough sounds and correlates with spectrogram morphology. Our study thus indicates that injection laryngoplasty may help avert aspiration in patients with glottic insufficiency by improving cough effectiveness and that improved cough airflow measures may be tracked with cough sounds.


Objective/Hypothesis

We explored the following hypotheses in a cohort of patients undergoing injection laryngoplasty: (1) glottic insufficiency affects voluntary cough airflow dynamics and restoring glottic competence may improve parameters of cough strength, (2) cough strength can be inferred from cough acoustic signal, and (3) glottic competence changes cough sounds and correlates with spectrogram morphology.

Study Type/Design

Prospective interventional study.

Methods

Subjects with glottic insufficiency secondary to unilateral vocal fold paresis, paralysis, or atrophy, and scheduled for injection laryngoplasty completed an instrumental assessment of voluntary cough airflow using a pneumotachometer and a protocolized voluntary cough sound recording. A Wilcoxon signed-rank test was used to compare the differences between pre- and post-injection laryngoplasty in airflow and acoustic measures. A Spearman rank-order correlation was used to evaluate the association between airflow and acoustic cough measures.

Results

Twenty-five patients (13F:12M, mean age 68.8) completed voluntary cough airflow measurements and 22 completed cough sound recordings. Following injection laryngoplasty, patients had a statistically significant decreased peak expiratory flow rise time (PEFRT) (mean change: −0.03 s, SD: 0.06, p = 0.04) and increased cough volume acceleration (mean change: 13.1 L/s2, SD: 33.9, p = 0.03), suggesting improved cough effectiveness. Correlation of cough acoustic measures with airflow measures showed a weak relationship between PEFRT and acoustic energy (coefficient: −0.31, p = 0.04) and peak power density (coefficient: −0.35, p = 0.02).

Conclusions

Our study thus indicates that injection laryngoplasty may help avert aspiration in patients with glottic insufficiency by improving cough effectiveness and that improved cough airflow measures may be tracked with cough sounds.

Level of Evidence

3 Laryngoscope, 2022

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