Tratamento integrado para correção do sorriso gengival: relato de caso / Integrated treatment for correction of gingival smile: case report

O sorriso gengival possui inúmeras causas, podendo acontecer por motivos esqueléticos, musculares ou por alteração no desenvolvimento dos tecidos de suporte. No entanto, na atualidade, a estética vermelha e a branca têm se apresentado completamente passíveis de transformações e com uma gama de procedimentos cirúrgicos ou não cirúrgicos para sanar as queixas dos pacientes. O objetivo geral deste trabalho é mostrar o poder que a odontologia tem frente às questões estéticas, como, por exemplo, a vergonha de sorrir por não se sentir confortável com os dentes curtos e com uma grande faixa de gengiva sendo exposta. O método utilizado foi um relato de caso. Que descreve todos os passos clínicos do tratamento de um paciente de 40 anos, que estava insatisfeita com o seu sorriso por apresentar erupção passiva alterada juntamente com hiperatividade do lábio superior. O plano de tratamento escolhido foi de realizar a cirurgia de aumento de coroa clínica estético, seguido de clareamento dentário e posteriormente um reposicionamento labial, com ajuda da toxina botulínica. Finalizando, para ajudar na cicatrização, o uso de laserterapia. O resultado de todo o processo cirúrgico envolvido neste trabalho, é satisfação do paciente, materializando o sonho deste, devolvendo segurança e espontaneidade ao sorrir. Pôde-se observar que através da combinação de técnicas cirúrgicas periodontais para tratar o sorriso gengival, obtém-se êxito tanto no sentido científico quanto no biológico, alcançando um sorriso esteticamente mais atrativo(AU)

Gummy smile has numerous causes, which can occur for skeletal or muscular reasons or due to changes in the development of supporting tissues. However, nowadays, the red and white aesthetics have been completely capable of transformation and with a range of surgical or non-surgical procedures to resolve patients' complaints. The general objective of this work is to show the power that dentistry has in the face of aesthetic issues, such as, for example, the shame of smiling due to not feeling comfortable with short teeth and a large strip of gum being exposed. The method used was a case report. Which describes all the clinical steps of the treatment of a 40-year-old patient, who was dissatisfied with her smile due to an altered passive eruption together with hyperactivity of the upper lip. The chosen treatment plan was to perform aesthetic clinical crown augmentation surgery, followed by tooth whitening and later lip repositioning, with the help of botulinum toxin. Finally, to help with healing, the use of laser therapy. The result of the entire surgical process involved in this work is patient satisfaction, materializing the patient's dream, restoring security and spontaneity when smiling. It was observed that through the combination of periodontal surgical techniques to treat gummy smile, success is achieved both in the scientific and biological sense, achieving a more aesthetically attractive smile(AU)

Reposicionamiento Labial. Caso Clínico

El reposicionamiento labial es un procedimiento quirúrgico mínimamente invasivo que se utiliza para tratar una sonrisa gingival, la cual, es una afección en la que una cantidad significativa de la encía queda expuesta cuando una persona sonríe y puede deberse a una variedad de factores, como un exceso de tejido gingival, un labio superior corto o músculos hiperactivos del labio superior, entre otros. El alargamiento clínico de la corona, por otro lado, consiste en eliminar el exceso de tejido gingival y, si es necesario, el tejido óseo para exponer una mayor parte de la corona natural del diente. Se reporta un caso clínico de paciente femenino de 31 años que presentó una sonrisa gingival provocada por hipermovilidad de labio superior y un exceso de tejido gingival localizado. El plan de tratamiento involucró una combinación de reposicionamiento labial y alargamiento de corona. Los resultados estéticos fueron significativos, con la sonrisa del paciente más equilibrada y proporcionada. Se redujo la cantidad de tejido gingival expuesto cuando la paciente sonreía y la longitud de los dientes fue más visible, lo que dio como resultado una sonrisa de aspecto más natural, además de aumentar su aceptación al sonreír.

SUMMARY: Lip repositioning is a minimally invasive surgical procedure used to treat a gummy smile, which is a condition in which a significant amount of the gum is exposed when a person smiles and may be due to a variety of factors, such as excess gum tissue, a short upper lip or overactive muscles of the upper lip, among others. Clinical crown lengthening, on the other hand, involves removing excess gingival tissue and, if necessary, bone tissue to expose more of the natural crown of the tooth. Clinical case: A clinical case of a 31-year-old female patient who presented a gummy smile caused by hypermobility of the upper lip and an excess of localized gingival tissue is reported. The treatment plan involved a combination of lip repositioning and crown lengthening. The aesthetic results were significant, with the patient's smile more balanced and displayed. The amount of the patient's exposed gum tissue when smiled was reduced and the length of the teeth was more visible, resulting in a more natural-looking smile, as well as increasing their acceptance of smiling.

Effectiveness of lip repositioning in the treatment of excessive gingival display: systematic review and meta-analysis / Eficacia del reposicionamiento de labios en el tratamiento de la exposición gingival excesiva: revisión sistemática y metanálisis

Background: The objective of this systematic review and meta-analysis was to answer the questions ''Does lip repositioning surgery reduce the amount of gingiva exposed in the smile in individuals with excessive gingival display EGD (excessive gingival display)?'' and ''Is the reduction of the amount of gingiva exposed when smiling obtained with lip repositioning surgery stable over time?'' to evaluate the effectiveness of lip repositioning surgery for correcting EGD on smiling. Materials and Methods: A systematic structured search was carried out in five databases without data restriction. Studies reporting the degree of reduction in gingival ex-posure after lip repositioning surgery were included. Study selection, data extraction, and risk of bias assessment were performed in duplicate Results: One hundred sixty-four references were retrieved and eleven studies met the eligibility criteria. Meta-analysis demonstrated that lip repositioning surgery results in a significant reduction in the amount of exposed gingival tissue (mean difference = -3.03; confidence interval = -3.55; -2.52). In addition, the results remained stable in the evaluated follow-up periods (1, 3, 6 and 12 months). Included studies had a low risk of bias. Conclusions: Lip repositioning surgery is effective for the treatment of EGD on smiling and exhibits stable results in the evaluated periods. The study was registered (CRD42020184866) in the international prospective register of systematic reviews (PROSPERO)

Antecedentes: el objetivo de esta revisión sistemática y metanálisis fue responder a las preguntas "¿La cirugía de reposicionamiento de labios reduce la cantidad de encía expuesta en la sonrisa en personas con exposición gingival excesiva (EGE)?" y "¿La reducción de la cantidad de encía expuesto al sonreír obtenido con cirugía de reposicionamiento de labios estable en el tiempo?" para evaluar la efectividad de la cirugía de reposicionamiento de labios para corregir la EGE al sonreír. Materiales y Métodos: Se realizó una búsqueda sistemática estructurada en cinco bases de datos sin restricción de datos. Se incluyeron los estudios que informaron el grado de reducción de la exposición gingival después de la cirugía de reposición de labios. La selección de estudios, la extracción de datos y la evaluación del riesgo de sesgo se realizaron por duplicado. Resultados: Se recuperaron ciento sesenta y cuatro referencias y once estudios cumplieron con los criterios de elegibilidad. El metanálisis demostró que la cirugía de reposicionamiento de labios da como resultado una reducción significativa en la cantidad de tejido gingival expuesto (diferencia de medias = -3,03; intervalo de confianza = -3,55; -2,52). Además, los resultados se mantuvieron estables en los periodos de seguimiento evaluados (1, 3, 6 y 12 meses). Los estudios incluidos tenían un bajo riesgo de sesgo. Conclusión: La cirugía de reposicionamiento de labios es efectiva para el tratamiento de la EGE al sonreír y presenta resultados estables en los períodos evaluados. El estudio fue registrado (CRD42020184866) en el registro prospectivo internacional de revisiones sistemáticas (PROSPERO).

Histone deacetylase (HDAC) inhibitors- based drugs are effective to control Mycobacterium tuberculosis infection and promote the sensibility for rifampicin in MDR strain

BACKGROUND Tuberculosis (TB) is a major public health problem, which has been aggravated by the alarming growth of drug-resistant tuberculosis. Therefore, the development of a safer and more effective treatment is needed. OBJECTIVES The aim of this work was repositioning and evaluate histone deacetylases (HDAC) inhibitors- based drugs with potential antimycobacterial activity. METHODS Using an in silico pharmacological repositioning strategy, three molecules that bind to the catalytic site of histone deacetylase were selected. Pneumocytes type II and macrophages were infected with Mycobacterium tuberculosis and treated with pre-selected HDAC inhibitors (HDACi). Subsequently, the ability of each of these molecules to directly promote the elimination of M. tuberculosis was evaluated by colony-forming unit (CFU)/mL. We assessed the expression of antimicrobial peptides and respiratory burst using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) FINDINGS Aminoacetanilide (ACE), N-Boc-1,2-phenylenediamine (N-BOC), 1,3-Diphenylurea (DFU), reduce bacillary loads in macrophages and increase the production of β-defensin-2, LL-37, superoxide dismutase (SOD) 3 and inducible nitric oxide synthase (iNOS). While only the use of ACE in type II pneumocytes decreases the bacterial load through increasing LL-37 expression. Furthermore, the use of ACE and rifampicin inhibited the survival of intracellular multi-drug resistance M. tuberculosis. MAIN CONCLUSIONS Our data support the usefulness of in silico approaches for drug repositioning to provide a potential adjunctive therapy for TB.

Humanistic Care in Clinical Diagnosis and Treatment of Elderly Benign Paroxysmal Positional Vertigo Patients / 中国医学伦理学

Benign paroxysmal positional vertigo (BPPV) is a peripheral vestibular disease with the highest incidence rate, and the elderly are the high incidence population. Particle repositioning maneuver, simple and practicable, and has good clinical effects, is recognized as the preferred treatment method for BPPV. However, the elderly patients have a higher prevalence rate, often suffer from multiple chronic diseases, and their various bodily functions have entered a declining stage, with poor response to treatment and a tendency to recur. Based on these, medical staff should continuously improve their professional abilities, and pay attention to and implement some comprehensive and multi-dimensional humanistic care measures from physiological to psychological aspects such as verbal encouragement, behavioral support, and spiritual integration during the diagnosis and treatment process, to improve the quality of life of elderly BPPV patients, reduce medical disputes, and save medical resources.

Geriatric benign paroxysmal positional vertigo: a single-center study

Abstract Objective To compare the clinical features, risk factors, distribution of Benign Paroxysmal Positional Vertigo (BPPV) subtypes, and effectiveness of canalith repositioning between geriatric and non-geriatric patients with BPPV. Methods A total of 400 patients with BPPV were enrolled. Canalith repositioning was performed according to the semicircular canals involved. Patients were divided by age into a geriatric group (≥60 years) and a non-geriatric group (20-59 years). Clinical characteristics, potential age-related risk factors, distribution of subtypes, and effectiveness of canalith repositioning were compared between the groups. Results Female sex was significantly more common in all age groups, with a peak female-to-male ratio of 5.1:1 in the group aged 50-59 years. There was a higher proportion of men in the geriatric group. A history of disease associated with atherosclerosis was significantly more common in the geriatric group (p< 0.05). Migraine was significantly more common in the non-geriatric group (p= 0.018), as was posterior canal BPPV. The horizontal canal BPPV (especially horizontal canal BPPV-cupulolithiasis), and multicanal BPPV subtypes were more common in the geriatric group, whereas anterior canal BPPV was more common in the non-geriatric group. Two canalith repositioning sessions were effective in 58.0% of the geriatric cases and in 72.6% of the non-geriatric cases (p= 0.002). There was a tendency for the effectiveness of canalith repositioning to decrease with increasing age. Conclusion BPPV was more common in women. However, the proportion of men with BPPV increased with age. Elderly patients often had a history of diseases associated with atherosclerosis (i.e., hypertension, diabetes, and hyperlipidemia). The horizontal canal BPPV (particularly horizontal canal BPPV-cupulolithiasis) and multicanal BPPV subtypes were more common and the anterior canal BPPV subtype was less common in elderly patients. The effectiveness of canalith repositioning may decrease with age. Therefore, older patients should receive more comprehensive medical treatment. Level of evidence: 4.

Antimicrobial activity of selective serotonin reuptake inhibitors in bacteria and fungi: a systematic review / Atividade antimicrobiana de inibidores seletivos de recaptação de serotonina em bactérias e fungos: uma revisão sistemática

Objective: this systematic review aims to compile literature data on the antimicrobial action of Selective Serotonin Reuptake Inhibitors (SSRI). Methods: To this end, the articles in this review were searched in the PubMed database between the years 2010 to 2020, using terms found in MESH as descriptors. The PRISMA flow diagram was used to analyze the process flow of the research. Later, inclusion and exclusion criteria and eligibility for data extraction and statistical analysis were applied. Results: Thus, of 252 articles found, 13 were used for this systematic review. The period in which there were more publications was in 2016-2017. All articles demonstrated the antimicrobial activity of ISRS, such as sertraline, fluoxetine, and paroxetine, in addition to their synergistic activity with some antifungals and antibacterial. Conclusion: With this, it could be concluded that the repositioning of non-antibiotic drugs that have antimicrobial activity is a promising alternative for the scientific community and, in the future, in clinical practice

Objetivo: compilar dados da literatura sobre a ação antimicrobiana dos Inibidores Seletivos de Recaptação de Serotonina (ISRS). Métodos: os artigos desta revisão foram pesquisados na base de dados PubMed, entre os anos de 2010 a 2020, utilizando, como descritores, termos encontrados no MESH. O fluxograma PRISMA foi utilizado para analisar o fluxo do processo da pesquisa. Posteriormente, foram aplicados os critérios de inclusão e exclusão e de elegibilidade para extração de dados e análise estatística. Resultados: dos 252 artigos encontrados, 13 foram utilizados para esta revisão sistemática. O período em que houve mais publicações foi em 2016-2017. Todos os artigos demonstraram a atividade antimicrobiana do ISRS, como sertralina, fluoxetina e paroxetina, além de sua atividade sinérgica com alguns antifúngicos e antibacterianos. Conclusão: o reposicionamento de medicamentos não antibióticos que possuam atividade antimicrobiana é uma alternativa promissora para a comunidade científica e, futuramente, na prática clínica.

Complex benign horizontal canal positional vertigo: new perceptual management

Abstract Objective: Horizontal semicircular canal site pathology of benign paroxysmal positional vertigo demonstrating three types of nystagmi on positional test were studied. We have attempted to design a protocol for its diagnosis and treatment. Methods: 320 patients of HSC-BPPV were subjected to two types of positional tests. Of these, patients with bilateral steady apogeotropic nysatgmus were treated with VAV modification of Semont's maneuver. Patients with unsteady or changing apo/geotropic signs were converted into steady geotropic ones by repetitive positional tests; followed by barbecue maneuver with forced prolong positioning. Results: Overall 88% of patients had a total recovery. 92% of patients with geotropic nystagmus showed no symptoms after second maneuveral sitting. 85% of patients with apogeotropic nystagmus recovered fully after third maneuveral sitting. Conclusion: Correct identification of subtypes of HSC-BPPV is based on provoked nystagmus by positional tests. After locating the site and side on the basis of nystagmic pattern, physician can apply the appropriate PRM. Level of evidence: II a.

Incidence of re-surgery after manual small-incision cataract surgery at a tertiary eye-care center in South India

Purpose: To study the incidence of re-surgery after manual small-incision cataract surgery (MSICS) at a tertiary eye-care center in South India and to compare the re-surgery rate between trainees and experts. Methods: A retrospective study was conducted at a tertiary eye-care center in Andhra Pradesh state of South India, which included 19,515 patients who underwent MSICS between 2012 and 2022 with 369 eyes of 369 patients who underwent re-surgery within 1 week of primary surgery. Factors included demographic data, type of re-surgery, that is, wound re-suturing, IOL repositioning, cortical wash, as well as anterior chamber (AC) wash. Results: 19,515 eyes from the year 2012�22 were analyzed. Most of the patients undergoing re-surgery belonged to the age group of 61� years (40.3%). Wound re-suturing was the more frequently performed re-surgery (47.6%). Wound re-suturing rates were comparable between the trainees and experts, whereas IOL repositioning, cortical wash, and AC wash were higher in the cases performed by trainees though statistically not significant. Conclusion: Careful pre-operative assessment, training under supervision, and other measures can be taken to reduce the re-surgery rates. Timely diagnosis and early treatment can give better outcomes and prevent devastating complications like endophthalmitis

Efectos posturográficos de la maniobra de Epley en pacientes con vértigo posicional paroxístico del canal posterior / Posturographic effects of the Epley maneuver on patients with benign paroxysmal positional vertigo of the posterior canal

Resumen Introducción: El vértigo posicional paroxístico benigno (VPPB) es la afección periférica más común en las enfermedades otoneurológicas. Con el reposicionamiento de partículas se busca eliminar el vértigo y sus síntomas asociados como lo son el mareo residual y la inestabilidad. Objetivo: Determinar si la maniobra de reposicionamiento de Epley (MRE) produce una modificación significativa del control postural (CP) en aquellos pacientes con VPPB de canal semicircular posterior (VPPB-CSC-P). Material y Método: Se realizó un estudio descriptivo prospectivo en una muestra de 21 pacientes con diagnóstico de VPPB-CSC-P. Comparamos el desplazamiento, la velocidad y el área del centro de presión (CoP) antes y después de la MRE. Resultados: La velocidad y el área de la CoP estudiada por posturografía computarizada muestra una disminución significativa en sus valores después de la MRE, mientras que el desplazamiento de la CoP se mantuvo sin cambios. Conclusión: La MRE ejecutada en pacientes con VPPB-CSC-P produce una modulación en el control de la CoP, demostrada por la disminución de la velocidad y el área de desplazamiento de la CoP. El éxito de la MRE produce modulación del CP.

Abstract Introduction: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral condition in otoneurologic diseases. With the repositioning of particles, the aim is to eliminate vertigo and its associated symptoms, such as residual dizziness and instability. Aim: To determine if the Epley repositioning maneuver (ERM) produces a significant modification of postural control (PC) in those patients with posterior semicircular canal BPPV (BPPV-CSC-P). Material and Method: A prospective descriptive study was carried out in a sample of 21 patients diagnosed with BPPV-CSC-P. We compared the displacement, velocity, and area of the center of pressure (CoP) before and after the Epley repositioning maneuver. Results: The velocity and the area of the CoP studied by computed posturography show a significant decrease in its values after the MRE, while the CoP shift remained unchanged. Conclusion: ERM performed in patients with BPPV-CSC-P produces an improvement in the control of the CoP, demonstrated by the decrease in the speed and the area of movement of the CoP. The success of the MRE produces modulation of the PC.

Comparing IOLM700 TK, Berdahl and Hardten astigmatism fix calculator and Barrett Rx formula in managing residual astigmatism due to toric intraocular lens misalignment

Purpose: To compare the accuracy in astigmatism reduction by using IOLM 700 steep total keratometry (TK) axis, Berdahl and Hardten astigmatism fix, and Barrett Rx formula following misaligned toric intraocular lens (IOL). Methods: Ten patients with residual refractive astigmatism due to misalignment following toric IOL implantation were included in this retrospective study. They were analyzed at days 4, 7/8, and 10/11 following primary cataract surgery on the platform of Berdahl and Hardten astigmatism fix, Barrett Rx formula, and IOLM 700 to determine the optimum axis of repositioning, and underwent IOL realignment on the steep TK axis of IOLM 700 assisted by the Callisto eye. The final outcome parameters were subjective refraction and orientation of toric IOL assessed 22 ± 1 days following repositioning surgery. These parameters were fed in the Barrett Rx formula and its vector analysis graph was utilized to determine the predicted ideal axis with the least residual astigmatism and the estimated residual astigmatism if the toric IOL was realigned according to the axis suggested by Berdahl and Hardten astigmatism fix and Barrett Rx formula. Results: Realigning the toric IOL on IOLM 700 steep TK axis along with the Callisto eye reduces the residual refractive astigmatism significantly (P = 0.003) from 2.00 ± 0.78 D to 0.18 ± 0.12 D (90.5 ± 7.6%) in comparison to the estimated 0.57 ± 0.31 D (68.4 ± 21.9%) by Berdahl and Hardten astigmatism fix and 0.61 ± 0.33 D (66.4 ± 23.5%) by Barrett Rx formula. Conclusion: Realigning the misaligned toric IOL on the IOLM 700 steep TK axis gives a better reduction in the residual refractive astigmatism in comparison to Berdahl and Hardten astigmatism fix and Barrett Rx formula

Innovative pharmaceutical strategies for niclosamide repositioning / Estratégias farmacêuticas inovadoras para o reposicionamento da niclosamida

The antiparasitic niclosamide has shown promising anticancer activity in preclinical studies against several types of cancer, such as colorectal and prostate. Thus, the objective of this work was to develop innovative formulations for the repositioning of niclosamide as an anticancer agent. In chapter I, a critical review of the literature on the physicochemical properties of the drug was carried out, in addition the results of clinical studies against colorectal and prostate cancer. Besides, a review was carried out on studies that developed formulations containing this drug, as well as hypotheses to improve the biopharmaceutical performance of this molecule. In chapter II, the development of solid amorphous dispersion containing niclosamide was carried out. Drug/polymer solutions were acoustic levitated and characterized by synchrotron X-ray light. This set allowed fast, high quality measurements, as well as the identification of niclosamide recrystallization. Plasdone® and Soluplus® demonstrated better properties to form amorphous dispersions, with the latter showing superior solubility enhancement. The study showed that the developed formulation increased the apparent saturation solubility of niclosamide in water by two times. In chapter III the objective was the development, physicochemical characterization and in vitro anticancer activity of a niclosamide nanoemulsion, having HCT-116 cells as a cellular model. Preliminary results indicated Capmul® MCM C8 as the best liquid lipid for the system, but the first nanoemulsions containing this lipid were not stable to justify its usage. On the other hand, Miglyol® 812 indicated to be a suitable liquid lipid for the system. The niclosamide nanoemulsion (~200 nm) with Miglyol® 812 and poloxamer 188 was stable for 56 days, with a monomodal particle size distribution. Cell viability assay against HCT-116 cells demonstrated that niclosamide cytotoxicity is time and concentration dependent. Results herein obtained encourage further research to understand and optimize niclosamide performance as an anticancer drug substance

O antiparasitário niclosamida tem apresentado promissora atividade anticâncer em estudos pré- clínicos contra diversos tipos de câncer, como coloretal e próstata. Assim, o objetivo deste trabalho foi desenvolver formulações inovadoras para o reposicionamento da niclosamida como agente anticâncer. No capítulo I foi realizada revisão crítica da literatura sobre as propriedades físico-químicas do fármaco, além de resultados de estudos clínicos da niclosamida contra câncer de coloretal e de próstata. Além disso, foi feita revisão sobre estudos que desenvolveram formulações contendo esse fármaco, bem como hipóteses para melhorar o desempenho biofarmacêutico dessa molécula. No capítulo II foi realizado o desenvolvimento de dispersão solida amorfa contendo niclosamida. Soluções de fármaco/polímero foram levitadas em levitador acústico e caracterizadas por raios-X de luz síncrotron. Este conjunto permitiu medições rápidas e de alta qualidade, bem como identificação de recristalização da niclosamida. Plasdone® e Soluplus® demonstraram melhores propriedades para formar as dispersões amorfas, com o último apresentando aumento de solubilidade superior. O estudo mostrou que a formulação desenvolvida aumentou em duas vezes a solubilidade aparente de saturação da niclosamida em água. No capítulo III o objetivo foi o desenvolvimento, a caracterização físicoquímica e atividade anticâncer in vitro de uma nanoemulsão de niclosamida, tendo células HCT-116 como modelo celular. Resultados preliminares indicaram o Capmul® MCM C8 como o melhor lipídio líquido para o sistema, mas as primeiras nanoemulsões contendo este lipídio não foram estáveis para justificar seu uso. Por outro lado, Miglyol® 812 indicou ser um lipídio líquido adequado para o sistema. A nanoemulsão de niclosamida (~200 nm) com Miglyol® 812 e poloxâmero 188 foi estável por 56 dias, com distribuição monomodal do tamanho de partícula. O ensaio de viabilidade celular contra células HCT-116 demonstrou que a citoxicidade da niclosamida é dependente do tempo e da concentração. Os resultados aqui obtidos encorajam mais pesquisas para entender e otimizar o desempenho da niclosamida como uma substância anticancerígena

Influencing factors of Toric intraocular lens postoperative rotation and its principles of treatment / 国际眼科杂志(Guoji Yanke Zazhi)

Correcting astigmatism safely and effectively has become a crucial part of modern cataract surgery due to the transformation of the surgery into a refractive procedure. The increased predictability and enhanced safety of Toric intraocular lens(IOL)implantation has made it the preferred method of correcting corneal regular astigmatism above 0.75D in cataract surgery. Toric IOL needs to be implanted in a precise axis position to achieve good astigmatism correction. A major cause of toric misalignment is postoperative rotation, which typically occurs soon after surgery. However, large axis misalignment will eliminate the astigmatism corrective effect of Toric IOL, even cause astigmatism in a new axis position. The factors responsible for IOL postoperative rotation are diverse. As a result, profound understanding of the factors is crucial for clinicians to minimize the rotation. Repositioning procedure is generally selected in case of significant rotation and the timing of the procedure is vital. This paper reviewed the influencing factors of IOL rotation postoperatively and its principle of treatment.

Identification of anthelmintic parbendazole as a therapeutic molecule for HNSCC through connectivity map-based drug repositioning

Head and neck squamous cell carcinoma (HNSCC) is one of the most common human cancers; however, its outcome of pharmacotherapy is always very limited. Herein, we performed a batch query in the connectivity map (cMap) based on bioinformatics, queried out 35 compounds with therapeutic potential, and screened out parbendazole as a most promising compound, which had an excellent inhibitory effect on the proliferation of HNSCC cell lines. In addition, tubulin was identified as a primary target of parbendazole, and the direct binding between them was further verified. Parbendazole was further proved as an effective tubulin polymerization inhibitor, which can block the cell cycle, cause apoptosis and prevent cell migration, and it exhibited reasonable therapeutic effect and low toxicity in the in vivo and in vitro anti-tumor evaluation. Our study repositioned an anthelmintic parbendazole to treat HNSCC, which revealed a therapeutic utility and provided a new treatment option for human cancers.

Effects of Customized Vestibular Rehabilitation on Static balance among Adults with Benign Paroxysmal Positional Vertigo (Kesan Rehabilitasi Vestibular Disesuaikan Ke Atas Keseimbangan Static Dalam Kalangan Dewasa Dengan Masalah Benign Paroxysmal Positional Vertigo) / Jurnal Sains Kesihatan Malaysia

@#The aim of this study was to detemine the effectiveness of Customized vestibular rehabilitation (CVR) in addition to the standard Canalith repositioning maneuver (CRM) on static balance among adults with posterior canal Benign Paroxysmal Positional Vertigo (BPPV). In this randomised controlled trial, 28 adults with idiopathic unilateral posterior canal BPPV were randomized to either the control or experimental group. The experimental group (n=14, mean age: 50.71±9.88 years) received CVR in addition to CRM, and the control group (n=14, mean age: 54.36±8.55 years) received only CRM for 6 weeks. Measurements of static balance (postural sway) using a portable kinematic sensor were performed at baseline, four and six weeks after treatment for both groups while standing on firm and foam surface with eyes open (EO) and closed (EC). Only standing on foam surface with EC was observed to have a significant interaction effect, F (2, 52) =5.28, p<0.05. This suggest that the groups were affected differently by the intervention and greater improvement was demonstrated in the experimental group. Post hoc test showed that a significant difference (p<0.05) in static balance was shown between baseline and 6th week after intervention. The results of our study indicate that CVR in addition to CRM improved static balance in adults with UPC BPPV at 6th week after intervention for persons with BPPV.

Conventional treatments and non-PEGylated liposome encapsulated doxorubicin for visceral leishmaniasis: A scoping review

Visceral leishmaniasis (VL), also known as Kala-azar, is caused by Leishmania (L.) donovani complex, which includes L. donovani and L. infantum and is associated with a high death rate as compared to the cutaneous and subcutaneous form. Treatment of VL includes chemotherapeutic agents which are associated with some major hurdles like toxicities, parenteral administration, high cost, parasite resistance and stability. Hence, there is an urgent requirement to develop novel chemotherapeutic agents or repurposing of existing drugs against VL. Developing formulation of new chemical entity for the treatment of VL is laborious, time consuming and associated with huge financial burden. However, screening of existing chemotherapeutic agents is a good alternative to avail cost-effective treatment option for VL. Non-PEGylated liposome encapsulated doxorubicin (Myocet ®) is proposed as an alternative treatment option for VL in this review article. Here, we covered the fundamental aspects of VL, loophole associated with available current treatment strategies and non-PEGylated liposome encapsulated doxorubicin as a novel alternative formulation for treating VL, as this liposomal delivery system of doxorubicin might passively target the intra- cellular regions of macrophage.

Artificial Intelligence Supports Research Progress in the Diagnosis and Treatment of Rare Diseases / 罕见病研究

It is noteworthy that only 5% of more than 7000 described rare diseases are treated. In the era of big data, there is ever-increasing data for understanding biomedicine. The need for efficient and rapid data collection, analyses and characterization methods is pressing. Rare diseases can particularly benefit from artificial intelligence (AI) application. AI, with an emphasis on machine learning, creates a path for such efforts and is being applied to diagnosis and treatment. AI has demonstrated its potential to learn and analyze data from different sources with results in prediction。Presently, there are AI-driven technologies applied for rare diseases and this review aims to summarize these advances. Moreover, this review scrutinizes the limitation and identifies the pitfalls of AI applications in the diagnosis and treatment of rare diseases.

Técnicas de reposicionamiento canalicular efectivas para rehabilitación del vértigo posicional paroxístico benigno / Técnicas de reposicionamiento canalicular efectivas para rehabilitación del vértigo posicional paroxístico benigno / Effective canalicular repositioning techniques for rehabilitation of benign paroxysmal positional vertigo

El Vértigo Posicional Paroxístico Benigno es uno de los diagnósticos más comunes y consultados en la práctica clínica de patologías de vértigo, por lo tanto, el presente artículo tiene como finalidad, describir las técnicas de reposicionamiento canalicular más utilizadas por Audiólogos expertos en rehabilitación vestibular específicamente para los conductos semicirculares de mayor prevalencia que se ven afectados en esta patología, los cuales son; el conducto semicircular posterior y el conducto semicircular horizontal, en contraste con las técnicas de mayor efectividad reportadas en la literatura. Lo anterior, sustentado en la aplicación de una encuesta, y, revisión de literatura especializada a través de una metodología con enfoque cualitativo y alcance descriptivo, se encuestó a doce Audiólogos especialistas en rehabilitación vestibular mediante la técnica bola de nieve. En cuanto a la revisión de literatura científica se tuvo en cuenta publicaciones de los últimos cinco años de bases de datos especializadas, seleccionando quince artículos de acuerdo con los criterios de inclusión, obteniendo como resultado que actualmente existe correspondencia entre las técnicas recomendadas en la literatura y las aplicadas en la práctica audiológica.

Benign Paroxysmal Positional Vertigo is one of the most common and consulted diagnoses in the clinical practice of vertigo pathologies, therefore, the purpose of this article is to describe the Canalicular repositioning techniques most used by expert Audiologists in vestibular rehabilitation specifically for the most prevalent semicircular canals that are affected in this pathology, which are the posterior semicircular canal and the horizontal semicircular canal, in contrast to the most effective techniques reported in the literature. The above, based on the application of a survey and review of specialized literature through a qualitative approach methodology with descriptive scope, twelve Audiologists specialized in vestibular rehabilitation were surveyed by means of the snowball technique. As for the review of scientific literature, publications of the last five years of specialized databases were taken into account, selecting fifteen articles according to the inclusion criteria, obtaining as a result that currently there is correspondence between the techniques recommended in the literature and those applied in audiological practice.

Zuma Modified Maneuver as a Treatment to Geotropic Lateral Semicircular Canal Benign Paroxysmal Positional Vertigo

Abstract Introduction Benign Paroxysmal Positional Vertigo (BPPV) is the most common vestibular disorder, resulting from detached otoliths that migrate to one of the semicircular canals - canalolithiasis - or one of the cupulas - cupulolithiasis. The present study is related to lateral canal BPPVs, which may be either geotropic or apogeotropic. The geotropic variant of lateral semicircular canal benign paroxysmal positional vertigo (LC-BPPV) is attributed to free floating particles in the posterior arm of the lateral semicircular canal. Objectives To verify the possibility of employing the Zuma repositioning maneuver, with a brief modification, as an alternative treatment for geotropic LC-BPPV. Methods Seven patients with geotropic LC-BPPV were enrolled and treated with the Zuma modified maneuver. Patients were reevaluated 1 hour after a single maneuver, to confirm the resolution of vertigo and positional nystagmus. Results All seven patients achieved immediate resolution of vertigo and positional nystagmus as measured 1 hour after the application of the maneuver. Conclusion The Zuma modified maneuver was effective for geotropic LC-BPPV after a single application. The use of the Zuma maneuver for both apogeotropic and geotropic LC-BPPV may simplify the treatment of these patients.

Management of internal derangement of temporomandibular joint disc displacement with reduction using two different lines of treatment / Manejo do desarranjo interno do deslocamento de disco temporomandibular com redução utilizando dois tipos diferentes de tratamento

Objetive: This study was to compare the effectiveness of arthrocentesis versus the insertion of anterior repositioning splint (ARS) in improving the mandibular range of motion (MRM) for patients with the temporomandibular joint (TMJ) anterior disc displacement with reduction (ADDwR). Methods: 36 patients diagnosed as ADDwR were recruited and divided randomly into two groups. The first group (G1) was treated by arthrocentesis, and the second (G2) was treated using ARS. All patients were reexamined after six months. Results: Except that for protrusive movement, there were significant differences between the two groups for the percentage changes of the MRM as measured by the amount of pain free opening, unassisted opening, maximum assisted opening, right lateral and left lateral movements (p < 0.05). Conclusion: Within the context of the current study, the non-invasive, lower cost ARS, provided better results in improving the MRM when managing ADDwR cases. (AU)

Objetivo: O presente estudo comparou a eficácia da Artrocentese em relação à inserção da Placa Reposicionadora Anterior (PRA) na melhoria da Amplitude de Movimento Mandibular (AMM) para pacientes que apresentam Deslocamento de Disco Anterior com Redução (DDAcR) da Articulação Temporomandibular (ATM). Método: 36 pacientes diagnosticados como DDAcR foram recrutados e divididos aleatoriamente em dois grupos. O primeiro grupo (G1) foi tratado através da Artrocentese e o segundo (G2), tratado com a PRA. Todos os pacientes foram reexaminados após seis meses. Resultados: Com exceção do movimento protrusivo, houve diferenças significativas entre os dois grupos para as mudanças percentuais das medidas de AMM pela quantidade de abertura sem dor, abertura sem assistência, abertura máxima com assistência, movimentos laterais direitos e laterais esquerdos (p < 0,05). Conclusão: Dentro do contexto do estudo atual, a PRA, não invasiva e de menor custo, proporcionou melhores resultados na melhoria da AMM no gerenciamento de casos de DDAcR (AU)