Medical Science Monitor最新文献

BACKGROUND This study included 32 patients with single missing teeth and alveolar bone defects and aimed to compare outcomes from guided bone regeneration with a gelatin/polylactic acid (GT/PLA) barrier membrane and a Guidor® bioresorbable matrix barrier dental membrane. MATERIAL AND METHODS A total of 32 participants were recruited in the clinical study, with single missing teeth and alveolar bone defects, requiring guided bone regeneration (32 missing teeth in total). They were randomly divided into the GT/PLA membrane group (experimental) and Guidor® membrane group (control) by the envelope method (n=16). Both membranes were used intraoperatively to cover the bone substitute material. Cone beam computed tomography (CBCT) was performed immediately and at 6 months after surgery to assess the amount of bone resorption. In addition, the osteogenic efficacy was calculated. The soft tissue index (STI), wound healing, membrane exposure, and incidence of infection in the operative area were evaluated. RESULTS The implant survival rate was 100% in both groups. The average bone resorption was 148.54±107.42 mm³ in the experimental group and 185.25±85.31 mm³ in the control group (P=0.163); the osteogenic efficacy was 75% in the experimental group and 56% in the control group (P=0.458). Moreover, the parameters of STI, wound healing, membrane exposure, and incidence of infection in the operative area showed no statistically significant difference between the 2 groups (P>0.05). CONCLUSIONS The GT/PLA barrier membrane yielded non-inferior clinical and imaging results to the GUIDOR® membrane, exhibiting good efficacy and biocompatibility in GBR.

BACKGROUND Ancylostoma caninum is a soil-borne, soil-transmitted helminth with infective larvae and produces cutaneous larva migrans in humans. The objective of this study was to confirm the presence of A. caninum in domestic dogs from the urban-marginal and rural sectors of the Ecuadorian coast through morphometry, culture, and molecular techniques. MATERIAL AND METHODS A total of 498 domestic dogs were analyzed via 5 coproparasitic screening methods: direct, modified flotation, sedimentation with centrifugation using saline solution (identification of eggs), and modified Baermann and Harada-Mori methods (identification of larvae). For confirmation, culture (agar in plates, Müller-Hinton agar plates, MacConkey agar plates, and artisanal media with sand and/or ravine soil, both sterile, and all prepared in Petri dishes), polymerase chain reaction (PCR), and DNA sequencing analyses were subsequently conducted via morphometric methods. RESULTS A total of 250 domestic dogs were diagnosed with A. caninum (50.20%) via coproparasitic methods. The parasite was subsequently confirmed via morphometry, cultured in 5 culture media, and detected by PCR, and phylogenetic characterization was performed. CONCLUSIONS The coproparasitic methods used for screening increased the sensitivity of the results. Morphometry is an easily accessible and low-cost confirmatory method. The culture method was used to test the good adaptability of and infection by the parasite. The presence of A. caninum was detected for the first time via PCR, and its phylogenetic profile was analyzed using the molecular marker cox1.

Skeletal muscle relaxants have their place in everyday use in numerous anesthesiological procedures, such as preparing a patient for surgery, supporting mechanical ventilation, and performing effective intubation. These drugs can be divided, based on their mechanism of action, into depolarizing skeletal relaxants, such as succinylcholine, and non-depolarizing skeletal muscle relaxants. Non-depolarizing agents are further categorized, based on their structure, into steroidal (eg, rocuronium) and benzylisoquinoline (eg, atracurium) compounds. To gain better control over neuromuscular blockade and patient recovery, a group of drugs known as reversal agents was developed. The effectiveness of skeletal muscle relaxants can be influenced by factors such as acid-base imbalances, impaired metabolism, and excretion, due to kidney or liver dysfunction, age, and sex. Skeletal muscle relaxants have also been used in neurosurgical procedures. It is believed that these drugs do not cross the blood-brain barrier. By reducing intrathoracic pressure and central venous pressure, they can lower intracranial pressure. However, in some studies, an increase in intracranial pressure has been observed. Therefore, selecting the appropriate drug is crucial, particularly for patients with suspected or confirmed elevated intracranial pressure, which is defined as the pressure within the intracranial space relative to atmospheric pressure. Elevated intracranial pressure above normal levels can occur in various conditions, such as sinus thrombosis, aneurysm rupture, brain tumors, intraventricular hemorrhage, and meningitis.In this article, we aim to review the role of muscle relaxants and reversal agents in neurosurgical procedures.

BACKGROUND This cone beam computed tomography (CBCT) endodontics study aimed to compare the canal-centering ability and canal transportation of Edgefile X7 and HyFlex EDM files in moderately curved mesiobuccal (MB) root canals of 30 mandibular first permanent molar teeth. MATERIAL AND METHODS Thirty permanent mandibular first molars with 10° and 24° of mesial root curvature were selected and scanned with CBCT. Two experimental groups of 15 each were made: group I: HyFlex EDM, and group II: Edgefile X7. The MB canals were instrumented, and CBCT scans were repeated. The distance from MB canal to the outer wall of the root was measured on pre- and post-instrumentation scans at 3 mm, 6 mm, and 9 mm from the apex. Canal transportation and centering ability were determined using established calculation methods. RESULTS For HyFlex EDM, average canal transportation was 0.01±0.17 mm, -0.10±0.21 mm, and 0.03±0.33 mm at 3 mm, 6 mm, and 9 mm, respectively; for Edgefile X7, average canal transportation was -0.02±0.21 mm, 0.07±0.22 mm, and -0.12±0.23 mm, respectively. HyFlex EDM group showed considerable canal transportation at 6 mm (P<0.05), while both groups showed non-significant differences at 3 mm and 9 mm. CONCLUSIONS At levels of 3 mm, 6 mm, and 9 mm, canal transportation was observed either on the mesial or distal surface of the canal curvature by HyFlex EDM and Edgefile X7 file systems. Compared with the HyFlex EDM file system, the Edgefile X7 file system showed reduced canal transportation and improved canal-centering ability.

Skeletal muscle relaxants have found wide application in anesthesiology. They are used during surgeries, to support mechanical ventilation, or as an aid for safe intubation. Their use is associated with the creation of a conduction block at the neuromuscular junction. To terminate the neuromuscular blockade or to prevent residual blockade, another group of drugs called reversal agents is used. These include drugs like neostigmine and sugammadex. Many factors may influence the duration and potency of skeletal muscle relaxants, including dysfunctions of organs such as the kidneys or liver. Liver damage can have various etiologies - it can be toxic drug-induced, or due to the ingestion of toxic substances, viral infections, or alcohol consumption. In recent years, there have been increasing reports on the impact of metabolic disorders on liver steatosis and damage. The liver is responsible for the metabolism of many drugs, the excretion of metabolites into bile, and protein production. Progressive liver damage can lead to its remodeling, and eventually to cirrhosis and failure. Liver dysfunction can be associated with numerous systemic complications. A decrease in protein synthesis causes a decrease in the binding of drugs to plasma proteins, a decrease in the volume of distribution, and an increased amount of free drug forms in the body. Liver failure can affect the metabolism of some skeletal muscle relaxants and neuromuscular blockade reversal agents. This article aims to review the role of muscle relaxants in anesthesia for patents with liver disease.

The Human Cell Atlas (HCA) Consortium was founded in 2016 as an open global initiative to map each cell type in the human body and create a three-dimensional (3-D) atlas. As of December 2024, 18 Biological Networks are assembling the first draft of the HCA from organs, tissues, and organ systems, including the heart, lung, liver, and immune system. Although the completed first version of the HCA should be released within a year, possibly two, the HCA Biological Networks are making the atlases available on the HCA Data Portal as they are released. Since 2016, the Consortium has grown to include more than 3,200 members from more than 1,700 institutes and now involves 99 countries to allow data from diverse geographic and ethnic groups and age ranges. The freely available data and cell maps will help transform future healthcare by improving the understanding of tissue-specific human cell biology in health and disease. This Editorial aims to provide an update on the current status of the HCA and highlights how this encyclopedia of cells will be an important step towards providing better care to individual patients, which will benefit all of humanity.

This publication has been retracted by the Editor due to the identification of non-original figure images and manuscript content that raise concerns regarding the credibility and originality of the study and the manuscript.Reference:Dunwei Wang, Pengcheng Liu. Ingenol-3-Angelate Suppresses Growth of Melanoma Cells and Skin Tumor Development by Downregulation of NF-kB-Cox2 Signaling.Med Sci Monit, 2018; 24: 486-502. DOI: 10.12659/MSM.906049.

BACKGROUND Vestibular schwannoma is a slow-growing benign tumor arising from the 8th cranial nerve. It can originate in the cerebellopontine angle (CPA). This retrospective study aimed to investigate the factors associated with outcomes following surgical resection of vestibular schwannoma in the CPA in 30 patients at a single center in Turkey, focusing on postoperative intratumoral hemorrhage. MATERIAL AND METHODS Thirty patients (mean age 42.8 years, range 17-81) underwent vestibular schwannoma surgery via a lateral suboccipital retrosigmoid approach. Patients were categorized as 'less bleeding' (n=15) or 'more bleeding' (n=15) based on the intraoperative nature of the tumor. Demographic characteristics, tumor size, extent of resection, postoperative intratumor bleeding rates, morbidity, and mortality were evaluated. RESULTS Mean tumor size was significantly larger in highly hemorrhagic tumors (3.8 cm, range 2.1-5 cm) compared with less hemorrhagic tumors (2.1 cm, range 1.8-3 cm) (P<0.001). Total resection was achieved in 60% of patients with highly hemorrhagic tumors >3 cm and chronic diseases, compared with 80% in less hemorrhagic tumors (P=0.02). Postoperative intratumoral hemorrhage occurred in 83.3% of subtotal resections in highly hemorrhagic tumors, versus 6.7% in less hemorrhagic tumors (P<0.001). CONCLUSIONS Larger vestibular schwannoma size is associated with increased hemorrhagic nature, complicating total resection. Subtotal resection in hemorrhagic tumors significantly increases the risk of postoperative bleeding and edema. When possible, total removal should be attempted to minimize complications. In cases requiring subtotal excision, careful postoperative management of coagulation and blood pressure is crucial.

BACKGROUND This study aimed to analyze the risk factors of central nervous system (CNS) infection caused by reactivation of varicella zoster virus (VZV) and provide reference for the prevention and early diagnosis of VZV-associated CNS infection. MATERIAL AND METHODS A prospective study was conducted on 1030 patients with acute herpes zoster (HZ) admitted to our hospital from January 2021 to June 2023. According to clinical manifestations and auxiliary examinations, they were divided into HZ group of 990 patients and VZV-associated CNS infection group of 40 patients. Differences in clinical characteristics and serum marker levels between the 2 groups were analyzed. RESULTS Compared with HZ group, the VZV-associated CNS infection group had a longer interval from onset to treatment, herpes mainly located in the head and neck, younger age, lower blood chloride and albumin levels, and higher levels of C-reactive protein and glutamyltranspeptidase (P<0.05, P<0.01). Logistic regression analysis found that prolonged interval from onset to treatment, herpes with craniocervical distribution, increased C-reactive protein, and decreased albumin content were independent risk factors for acute herpes zoster complicated with CNS infection (P<0.05). Combined with these 4 indicators to predict CNS infection, the AUC was 0.787, sensitivity was 64.5%, and specificity was 81.9%. CONCLUSIONS Identifying the risk factors for CNS infection caused by VZV reactivation is helpful for early screening. Clinicians should pay attention to acute HZ patients with delayed treatment, herpes occurring in the head and neck, elevated C-reactive protein levels, and decreased albumin levels. Early intervention can reduce the incidence of concurrent CNS infections.

BACKGROUND Ventriculoperitoneal (VP) shunt surgery is a widely used procedure for managing hydrocephalus; however, postoperative infections remain a serious complication, increasing morbidity and mortality. Known risk factors include prior surgeries, steroid use, and concurrent procedures. However, the role of liver cirrhosis, a condition that compromises immune function and predisposes patients to infections, has not been fully investigated in the context of neurosurgery. Current literature lacks large-scale studies evaluating whether liver cirrhosis increases infection risk after VP shunt surgery. This study aims to address this gap using a nationally representative database, to compare the risk of postoperative infections in patients with and without liver cirrhosis following VP shunt surgery, utilizing data from the Taiwan National Health Insurance Research Database (NHIRD). MATERIAL AND METHODS A retrospective cohort study analyzed 1766 patients with and 37 995 patients without liver cirrhosis who underwent their first VP shunt surgery between January 2010 and December 2019. Infection risk was assessed at 6 months and 1 year after surgery. Additional factors, such as cerebral hemorrhage, aneurysm, brain tumors, decompressive craniectomy, and cranioplasty, were considered. Fine and Gray regression accounted for death as a competing risk. RESULTS After we adjusted for potential confounders, patients with cirrhosis showed a 1.41-fold increased risk of infection at 6 months (95% CI: 1.10-1.81, P=0.007) and 1.39-fold at 1 year (95% CI: 1.12-1.73, P=0.003) compared with patients without cirrhosis. CONCLUSIONS Liver cirrhosis significantly elevates infection risk following VP shunt surgery, highlighting the need for tailored perioperative strategies to improve outcomes for these patients.