Medical Science Monitor : International Medical Journal of Experimental and Clinical Research最新文献

BACKGROUND This study aimed to compare fused deposition modeling (FDM) and digital light processing (DLP) techniques in terms of dimensional accuracy for printing dental models used for the manufacture of clear dental aligners. MATERIAL AND METHODS Based on the intraoral scan of an adult patient, a sequence of 10 aligner models was created using BlueSkyPlan4. The test models (n=30) were fabricated with 2 desktop 3D printers: (DLP) and (FDM) printers. Two groups of samples were created (digitized using a desktop optical scanner). To calculate trueness (n=20) and precision (n=10), printed models were compared to the source files (REF). REF, DLP, and FDM files were superimposed and converted to point clouds. The cloud-to-cloud distances were calculated using CloudCompare software. Using the same algorithm, distortions of models were measured. Data were analyzed using one-way ANOVA and Tukey's post hoc test. RESULTS Significant differences were found between the trueness and precision of DLP and FDM groups. The average calculated trueness of DLP and FDM was 0.096 mm (0.021) (P<0.001) and 0.063 mm (0.024) (P<0.001), respectively. The average calculated precision of DLP and FDM was 0.027 mm (0.003) (P<0.001) and 0.036 mm (0.003) (P<0.001), respectively. A widening (0.158 mmfor DLP and 0.093 mmfor FDM, P=0.05) and twisting (0.03 mmfor DLP and 0.043 mmfor FDM, P=0.05) of the printed models was observed. CONCLUSIONS Both printers had sufficient precision for aligner models manufacturing. FDM showed a higher trueness and this device can be applied as an alternative to DLP. Polymerization shrinkage is a significant factor in decreasing the trueness of DLP printers.

BACKGROUND This study aimed to evaluate the effects of alcohol intake, assessed using the Alcohol Use Disorder Identification Test (AUDIT) questionnaire, on the severity of plaque psoriasis using the Body Surface Area (BSA) and Psoriasis Area and Severity Index (PASI) scales, and quality of life using the Dermatology Life Quality Index (DLQI) questionnaire. MATERIAL AND METHODS The diagnosis of psoriasis was made based on the clinical picture. We enrolled 24 patients with psoriasis vulgaris, and the AUDIT test conducted at the time of follow-up indicated a possible risky/harmful pattern of alcohol consumption or alcohol dependence syndrome among the patients (>8 points). The comparison group consisted of 20 psoriatic patients and AUDIT <8 points. The BSA and PASI scales were used to determine the severity of psoriasis, and the DLQI questionnaire assessed patients' quality of life and how they felt during the week preceding the survey. RESULTS As the amount and frequency of alcohol consumed increased, the exacerbation of lesions measured according to the PASI and BSA scales was significantly higher (P<0.05), and the quality of life decreased (P<0.05). We noted that inadequate and excessive dietary intake of total protein, total fat, and assimilable carbohydrates were associated with statistically significantly higher values of BSA and PASI scores and, thus, more severe psoriatic lesions (P<0.05). CONCLUSIONS An unbalanced diet, alcohol abuse, and smoking negatively affect the course of psoriasis vulgaris, hence the importance of patient education.

Type 1 diabetes mellitus affects adults and children, with an increasing number of newly-diagnosed cases each year. Type 1 diabetes involves a primary functional defect in pancreatic islet beta cells, resulting in secondary autoimmunity that results in T-cell-mediated beta cell death. However, pancreatic transplantation is a complex procedure, with complications that include transplant organ failure due to rejection or ischemia-reperfusion injury, safety issues of the duodenal-duodenal anastomosis technique, and the availability of segmental or whole organs. On June 28, 2023, the FDA Center for Biologics Evaluation and Research (CBER) approved Lantidra (donislecel), the first allogeneic (deceased donor) pancreatic islet cell therapy for the treatment of adults with type 1 diabetes who do not achieve target glycated hemoglobin levels because of repeated episodes of severe hypoglycemia, despite current management. This Editorial aims to highlight the increasing global health burden of type 1 diabetes, previous approaches to pancreatic transplant methods and introduces the first regulatory approval for allogeneic pancreatic islet beta cell infusion, a novel approach to transplantation.

BACKGROUND Hyperparathyroidism poses significant risks for patients prior to kidney transplantation. However, the outcomes of patients who undergo parathyroidectomy before renal transplantation compared to those without such a procedure remain uncertain. This real-world data study aimed to examine the clinical outcomes of both patient groups. MATERIAL AND METHODS Using the Taiwan National Health Insurance Research Database, we conducted a retrospective cohort study on patients who underwent renal transplantation between January 2005 and December 2015. The patients were divided into two groups: a case group (n=294) with parathyroidectomy and a control group (n=588) without the need for parathyroidectomy before kidney transplantation. The groups were matched based on age, sex, dialysis vintage, and baseline characteristics at a 1:2 ratio. Hazard ratios (HR) were estimated using the Cox regression model. The main outcomes assessed were graft failure, mortality, and major adverse cardiovascular events (MACE) recorded until December 2019. RESULTS During a mean follow-up period of 6 years, a significant difference was observed in graft failure (HR 1.40; 95% confidence interval 1.10-1.79, p=0.007) between the two groups. After further adjustment, graft failure remained significant (HR 1.52; 95% CI 1.07-2.15, p=0.019). Additionally, machine learning-based feature selection identified the importance of parathyroidectomy (ranked 9 out of 11) before kidney transplantation in predicting subsequent graft failure. CONCLUSIONS Our study demonstrates that severe hyperparathyroidism requiring parathyroidectomy before kidney transplantation may contribute to poor post-transplant graft outcomes compared to patients who do not require parathyroidectomy.

BACKGROUND Lactate/albumin (LA/ALB) and procalcitonin/albumin (PCT/ALB) ratios have been implicated in predicting mortality in sepsis patients. However, their prognostic value and relationship to sepsis severity require further investigation. This retrospective study aimed to assess the prognostic value of lactate/albumin (LA/ALB) and procalcitonin/albumin (PCT/ALB) ratios in septic patients admitted to the Intensive Care Unit (ICU). MATERIAL AND METHODS A total of 340 adult sepsis patients admitted to the ICU were included in the derivation cohort. LA/ALB and PCT/ALB ratios were calculated and analyzed in relation to sepsis severity and survival status. Additionally, a validation cohort of 75 sepsis patients from another medical center was selected. RESULTS In the derivation cohort, higher LA/ALB and PCT/ALB ratios and SOFA scores were significantly associated with increased mortality (P<0.001). The LA/ALB and PCT/ALB ratios positively correlated with SOFA score. Survival analysis revealed significantly higher 28-day mortality in sepsis patients with elevated PCT/ALB (≥0.256) and LA/ALB (≥0.079) ratios upon ICU admission. The constructed prediction model incorporating LA/ALB ratio, PCT/ALB ratio, and SOFA score yielded an AUC of 0.826, demonstrating good predictive ability. The associations between LA/ALB and PCT/ALB ratios and 28-day mortality in sepsis patients were validated in the validation cohort. CONCLUSIONS The LA/ALB and PCT/ALB ratios at ICU admission provide valuable prognostic information for predicting 28-day mortality in sepsis patients. Combining these ratios with SOFA score improves the assessment of prognosis in sepsis patients.

Bone defects and dysfunctions are prevalent among patients, resulting from various causes such as trauma, tumors, congenital malformations, inflammation, and infection. The demand for bone defect repair materials is second only to blood transfusions. Artificial bone composites offer numerous advantages for bone damage repair, including their availability, absence of rejection or immune reactions, high malleability, exceptional mechanical strength, and outstanding biocompatibility. However, bacterial infections frequently occur during bone transplantation or on graft material structures, leading to severe complications such as osteomyelitis and osteoporosis. Moreover, existing osteogenic materials alone are inadequate to address the challenges posed by traumatic infections, presenting a significant hurdle for clinicians in reconstructing infectious bone defects. Consequently, it is crucial to functionalize artificial bone composites to facilitate effective bone repair and regeneration. Notably, antibacterial capabilities play a critical role in preventing and treating infectious bone defects, and current research is focusing on the interface between artificial bone composites and antibacterial treatments. This article provides an extensive review of the current state of artificial composite bone scaffolds with antibacterial properties for infection prevention in bone grafting.

Central serous chorioretinopathy (CSCR) is a relatively common retinal disease involving the localized serous detachment of the neurosensory retina from the retinal pigment epithelium (RPE). Research suggests that individuals with a Type A personality, exhibiting traits such as competitiveness, urgency, aggression, and hostility, are significantly more prone to developing CSCR. Several studies have confirmed that a propensity to stress as well as different stressful events may predispose subjects to the development and recurrence of CSCR. Patients with CSCR are more depressive, report a higher level of anxiety and use more psychopharmacologic medications. Despite the research conducted on the topic, it remains unclear how a variety of psychological factors can contribute to dysfunction and pathological changes in the choroid and RPE. Some authors propose that increased levels of sympathetic neurotransmitters and glucocorticoids may alter the choroidal blood flow and increase the permeability of choriocapillaris in CSCR patients. It is generally accepted that hyperpermeable choroidal vessels are responsible for increased tissue hydrostatic pressure, which promotes RPE detachment, breaks the barrier function of the RPE and leads to subretinal fluid accumulation. Although the etiological factors and pathophysiological mechanisms have still not been fully clarified, CSCR is most likely a multifactorial disease involving disturbed interrelationships between biological and psychological factors. This comprehensive review aims to provide an up-to-date exploration of the psychological factors and pathophysiological mechanisms associated with CSCR.

BACKGROUND The Turkey-Syria earthquake of February 6, 2023, impacted 11 provinces and necessitated widespread emergency medical support. Although not at the disaster's epicenter, Ankara Mamak State Hospital in Ankara, Turkey, offered critical multidisciplinary support. This retrospective study evaluates the factors that drove 124 admissions to the hospital's Emergency Department (ED) following the earthquake. MATERIAL AND METHODS We recorded patient demographic data, dates of arrival at the ED, provinces of origin, diagnoses, treatments, consultations during the ED visit, and patient outcomes. The majority of the 124 admissions were due to trauma and multi-organ damage, and the primary diagnostic tools were physical examination and radiological imaging. Of these patients, 85.5% (106) recovered and were discharged directly from the ED, 11 were admitted for continued care, and 7 were referred to another hospital. RESULTS The 124 cases consisted of adults injured within the first 20 days post-earthquake, with a mean age of 46.5±17.4 years, and a higher number of females. A peak in admissions was observed on the third and fourth days following the earthquake, with the most cases originating from the Hatay province. The most frequently injured body region was the lower extremity, and orthopedic consultations significantly outnumbered other surgical consultations. CONCLUSIONS Our findings underscore the vital role of robust, multidisciplinary disaster preparedness in all EDs, especially in regions prone to natural disasters.

The Editors of Medical Science Monitor wish to inform you that the above manuscript has been retracted from publication due to concerns with the credibility and originality of the study, the manuscript content, and the Figure images. Reference: Jing Gong, Yongxi Song, Ling Xu, Xiaofang Che, Kezuo Hou, Tianshu Guo, Yu Cheng, Yunpeng Liu, Xiujuan Qu. Upregulation of Serine Proteinase Inhibitor Clade B Member 3 (SERPINB3) Expression by Stromal Cell-Derived Factor (SDF-1)/CXCR4/Nuclear Factor kappa B (NF-kB) Promotes Migration and Invasion of Gastric Cancer Cells. Med Sci Monit, 2020; 26: e927411. DOI: 10.12659/MSM.927411.

BACKGROUND Adenovirus infections are prevalent in children, typically presenting with mild or asymptomatic symptoms. However, some children develop severe pneumonia necessitating hospitalization. This retrospective study aimed to identify risk factors associated with severe adenovirus pneumonia in children. MATERIAL AND METHODS We screened consecutive children admitted for community-acquired pneumonia at the Emergency Department of Guangzhou Women's and Children's Medical Center between 2017 and 2019. Adenovirus infection was confirmed through rapid respiratory virus assay, RT-PCR assay from respiratory secretions, or serum IgM antibodies. According to Chinese guidelines, patients with pneumonia were classified into severe and mild groups. We assessed risk factors for severe adenovirus pneumonia by comparing clinical features and laboratory indicators, then included differing factors between the 2 groups in a logistic regression analysis. Data analysis was performed using SPSS 26.0 software. RESULTS Our study included 173 children diagnosed with adenovirus pneumonia (117 severe, 56 mild). The median age was 40 months, with 64 male patients. Univariate analysis and binary logistic regression analysis revealed that pleural effusion (13.449 [1.226-147.510], p=0.033), electrolyte disturbances (15.149 [2.724-84.246], p=0.002), oxygen therapy (258.219 [20.684-3223.548], p<0.001), bronchoscopy (26.781 [6.088-117.805], p<0.001), and steroid administration (6.584 [1.497-28.953], p=0.013) were associated with the severity of adenovirus pneumonia. CONCLUSIONS This single-center retrospective study identified pleural effusion, the need for bronchoscopy, oxygen therapy, and steroid treatment, along with impaired serum electrolytes, as factors associated with severe adenovirus pneumonia in children.