Oral maxillofacial surgeons and Orthodontists' perceptions about anterior inferior crowding and indications of mandibular third molar extraction.

BACKGROUND: There are still many doubts about anterior inferior crowding and indications of mandibular third molar extraction, although it is very studied subject in the literature. The aim of this study was to evaluate the perceptions of oral maxillofacial surgeons (OMFSs) and orthodontists about anterior inferior crowding and indications of mandibular third molar extraction. MATERIAL AND METHODS: A web-based survey was developed and sent to professionals in order to collect their opinion about the fact that third lower molars cause crowding and questions about the indication of third molars for orthodontic treatment. Descriptive analysis was performed and Chi-square or G tests were applied with a 95% confidence interval. RESULTS: The study included a total of 218 participants, of whom 115 were OMFSs and 103 were orthodontists. The results showed that 56.5% of OMFSs and 35.0% of orthodontists believe that the lower third molars cause anterior inferior crowding (p<0.001). A total of 91.3% of OMFSs and 70.9% of orthodontists indicate the extraction of lower third molars to aid orthodontic treatment (p<0.001). CONCLUSIONS: It can be concluded that in being an oral maxillofacial surgeon, a higher odds ratio is observed to consider that lower third molars cause dental crowding compared to those who are orthodontist. The indication of exodontia of lower third molars for orthodontic treatment was more frequent among OMFSs when compared to orthodontists.

γδ-Enriched CAR-T cell therapy for bone metastatic castrate-resistant prostate cancer.

Immune checkpoint blockade has been largely unsuccessful for the treatment of bone metastatic castrate-resistant prostate cancer (mCRPC). Here, we report a combinatorial strategy to treat mCRPC using γδ-enriched chimeric antigen receptor (CAR) T cells and zoledronate (ZOL). In a preclinical murine model of bone mCRPC, γδ CAR-T cells targeting prostate stem cell antigen (PSCA) induced a rapid and significant regression of established tumors, combined with increased survival and reduced cancer-associated bone disease. Pretreatment with ZOL, a U.S. Food and Drug Administration-approved bisphosphonate prescribed to mitigate pathological fracture in mCRPC patients, resulted in CAR-independent activation of γδ CAR-T cells, increased cytokine secretion, and enhanced antitumor efficacy. These data show that the activity of the endogenous Vγ9Vδ2 T cell receptor is preserved in CAR-T cells, allowing for dual-receptor recognition of tumor cells. Collectively, our findings support the use of γδ CAR-T cell therapy for mCRPC treatment.

HBP/O-GlcNAcylation Metabolic Axis Regulates Bone Resorption Outcome.

Osteoclasts play a key role in the regulation of bone mass and are highly active metabolically. Here we show that a metabolic reprogramming toward the hexosamine biosynthetic pathway (HBP) is required not only for osteoclast differentiation but also to determine the bone resorption mode during physiological and pathological bone remodeling. We found that pharmacological inhibition of O-GlcNAc transferase (OGT) significantly reduced protein O-GlcNAcylation and osteoclast differentiation. Accordingly, genetic deletion of OGT also inhibited osteoclast formation and downregulated critical markers related to osteoclasts differentiation and function (NFATc1, αvintegrin, cathepsin K). Indeed, cells treated with OSMI-1, an OGT inhibitor, also reduced nuclear translocation of NFATc1. Furthermore, the addition of exogenous N-acetylglucosamine (GlcNAc) strongly increased osteoclast formation and demineralization ability. Strikingly, our data show for the first time that O-GlcNAcylation facilitates an aggressive trench resorption mode in human cells. The incubation of osteoclasts with exogenous GlcNAc increases the percentage of erosion by trench while having no effect on pit resorption mode. Through time-lapse recording, we documented that osteoclasts making trenches moving across the bone surface are sensitive to GlcNAcylation. Finally, osteoclast-specific Ogt-deficient mice show increased bone density and reduced inflammation-induced bone loss during apical periodontitis model. We show that osteoclast-specific Ogt-deficient mice are less susceptible to develop bacterial-induced periapical lesion. Consistent with this, Ogt-deleted mice showed a decreased number of tartrate-resistant acid phosphatase-positive cells lining the apical periodontitis site. In summary, here we describe a hitherto undiscovered role of the HBP/O-GlcNAcylation axis tuning resorption mode and dictating bone resorption outcome.

Clinical Efficacy of Mouthwashes with Potassium Salts in the Treatment of Dentinal Hypersensitivity: A Systematic Review and Meta-analysis.

AIM: This systematic review and meta-analysis evaluated whether the home use of mouthwashes containing potassium salts is effective in reducing and controlling dentin hypersensitivity (DH). METHODS AND MATERIALS: This study is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist and was registered in PROSPERO (CRD42021228410). Randomized clinical trials evaluating the use of mouthwashes containing potassium salt for daily household mouthwash for at least four weeks to reduce DH compared with a control mouthwash were selected, with no limitation on year of publication. Electronic research was carried out in PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library by two independent researchers. One hundred thirty-three articles were obtained, and nine were selected according to the inclusion criteria. RESULTS: The selected studies evaluated DH through tests of sensitivity to tactile and evaporative stimuli and showed that, for the tactile stimulus, there were no baseline differences between groups (p=0.12; mean difference: -0.33; confidence intervals [CI]: -0.73 to 0.08). However, there were significant differences after two weeks of use (p=0.00001; mean difference: 4.67; CI: 4.53 to 4.81), after four weeks (p=0.00001; mean difference: 13.29; CI: 13.03 to 13.55), and after eight weeks (p=0.00001; mean difference: 8.88; CI: 5.73 to 12.02) favoring the experimental group. The results of the evaporative test showed no differences in the baseline assessment between the two groups (p=0.50; mean difference: -0.02; CI: -0.09 to 0.04), but after four weeks (p=0.00001; mean difference: -0.32; CI: -0.44 to -0.20), and eight weeks of use (p=0.00001; mean difference: -0.42; CI: -0.57 to -0.27) there were differences favoring the experimental group. The incidence of side effects showed no differences between the two groups (p=0.89; mean difference: 1.03; CI: 0.67 to 1.58). CONCLUSION: The daily use of mouthwashes containing potassium salt is effective in the treatment of dentinal hypersensitivity, as a complementary step to brushing at least twice a day for two weeks, four weeks, and up to eight weeks, without presenting side effects.

Three-dimensional real and virtual models in fetal surgery: reality or a futuristic vision?

While relatively new, fetal surgery has become an indispensable part of the field of Obstetrics as it allows potentially life-threatening conditions to be corrected in utero. Imaging modalities such as ultrasound, magnetic resonance imaging, and computer tomography have become staples in fetal imaging, as they allow for comprehensive analysis of the fetal anatomy. Uses of these modalities can range from chromosomal diagnosis to surgical planning. Scientific development has not only allowed for visualization in the three-dimensional plane, but the implementation of virtual reality technology is also now a possibility. It is our belief that integrating virtual reality technology will help overcome hurdles currently faced by fetal surgeons including candidate selection and clearly observing fetal anatomy. Training opportunities are also probably, as surgeons and residents can use models created during these virtual reality experiences to study and prepare for complications that may arise during surgical intervention. This article is protected by copyright. All rights reserved.

Attenuation of the levels of pro-inflammatory cytokines prevents depressive-like behavior during ethanol withdrawal in mice.

Clinical studies indicate that alcohol-dependent patients may develop depressive symptoms during abstinence, which may increase the likelihood of relapse. It is known that both in alcohol exposure and depression, there is an increase in the levels of pro-inflammatory cytokines in the brain. However, the putative contribution of increased levels of pro-inflammatory cytokines in the development of depressive-like behavior during ethanol withdrawal has not been evaluated. In the present study, we aimed to investigate if ethanol withdrawal-induced depressive-like behavior is related to increased levels of pro-inflammatory cytokines in the brain. Male mice were treated with vehicle (saline 0.9%, v.o.) or ethanol (2 g/kg, v.o.) for 14 days. After 5 days of cessation of the ethanol treatment, mice were subjected to the forced swim test (FST), tail suspension test (TST), and open field test (OFT) and then sacrificed. Their brains were analyzed for the levels of pro-inflammatory cytokines. Ethanol withdrawal mice showed increased immobility time in the FST and TST than by the control group, indicating increased depressive-like behavior. No alterations in OFT were observed. Ethanol withdrawal increased the levels of tumor necrosis factor-alpha (TNF-α) in the hippocampus and striatum, interleukin-1 beta (IL-1ß) in the hippocampus, and IL-6 in the prefrontal cortex and hippocampus. Treatment of mice with nimesulide (5 or 10 mg/kg/day), a cyclooxygenase-2 inhibitor, during ethanol withdrawal prevented the increase in immobility time in the TST. Similar results were observed in the FST upon nimesulide treatment, although with a higher dose. Nimesulide treatment (10 mg/kg) prevented the ethanol withdrawal-induced alterations in the levels of TNF-α, IL-1ß, and IL-6 in the hippocampus, prefrontal cortex, and striatum. Treatment of mice with an atypical antidepressant drug, vilazodone (0.3 or 1 mg/kg) prevented the increase in depressive-like behavior induced by ethanol withdrawal in the TST. In the FST, the increase in immobility time was prevented only by 1 mg/kg vilazodone treatment. Vilazodone prevented the increase in the levels of TNF-α, IL-1ß, and IL-6 in the hippocampus, IL-6 in the prefrontal cortex, and TNF-α in the striatum. In conclusion, these data indicate that increased levels of pro-inflammatory cytokines may play a role in the development of depressive-like behavior during ethanol withdrawal in mice.

Polymorphism in the pvcrt-o and pvmdr-1 genes of Plasmodium vivax associated with a better prognosis for malaria.

The early molecular identification of strains of Plasmodium vivax that have a worse prognosis is important to stratify the risk of complications and choice of conduct made by medical teams. Thus, the aim of the present study was to associate the presence of polymorphisms in the pvmdr-1 and pvcrt-o resistance genes of P. vivax in patients with better or worse prognosis. This cross-sectional epidemiological study was conducted based on data obtained from the records of 120 patients diagnosed with malaria in the Brazilian Amazon. The T958M and F1076L mutations of the pvmdr-1 gene had a frequency of 3.3 and 4.2%, respectively, and primo-infected patients had a 17 times greater chance of being infected with protozoa with the T958M mutation compared to patients with previous episodes. Regarding pvcrt-o, the C393T and T786C polymorphisms had a frequency of 14.2 and 3.3%, respectively, and self-declared white patients had a 3.1 times greater chance of being infected with protozoa with the C393T polymorphism. In addition, patients with this pvcrt-o polymorphism had lower concentrations of C-reactive protein, indicating a better prognosis. These data present clues of genetic indicators useful for assessing the virulence of the parasite and the prognosis of patients with vivax malaria.

Analysis of Trifecta Results in a Single-Center Experience with Retroperitoneoscopic Partial Nephrectomy: An Observational Study

Objective: To analyze the trifecta results in patients with T1a and T1b renal tumors treated with retroperitoneoscopic partial nephrectomy (RPN). Material and Methods: A cross-sectional prospective observational study was conducted on 106 patients with cT1 renal tumor submitted to RPN. Trifecta was reported as no ≥ 2 Clavien-Dindo complications, warm ischemia time (WIT) ≤ 25 minutes, ≤ 15% postoperative ΔGFR, and nonpositive margins. Results: The mean age was 58 years (SD ± 12). The median (Q1; Q3) tumor size was 3.5 (2.2; 4.5) cm. Of the treated patients, 33% had a ventral tumor. R.E.N.A.L nephrometry score was low complexity in 54% of cases and high complexity in 4%. WIT median (Q1; Q3) was 20 (14; 23) minutes. Estimated blood loss median (Q1; Q3) was 50 (0; 100) ml. There were no conversions to open surgery. ΔGFR was >15% in 17.5% of patients. There were no postoperative complications in 84% of cases. Nonpositive margins were observed. Sixty-eight percent were pT1a and 32% were pT1b. Seventy-two percent of patients presented trifecta. A statistically significant difference was found between trifecta and tumor size (3 cm vs. 4.4 cm; p<0.001), complexity (low complexity 90% vs. intermediate complexity 56%; p<0.0001), and pT (T1a 81% vs. T1b 53%; p<0.003). Conclusion: RPN is a safe and effective treatment modality for T1a and T1b renal tumors. Trifecta rate was 72%. Tumor size, tumor complexity, and pT were found to be an associated factor for trifecta (AU)

Objetivo: Analizar los resultados trifecta en pacientescon tumores renales T1a y T1b tratados con nefrectomíaparcial retroperitoneoscópica (NPR).Material y Métodos: Se realizó un estudio observacional prospectivo de corte transversal en 106 pacientescon tumor renal cT1 sometidos a NPR. Se informó Trifectacomo no complicaciones de Clavien-Dindo ≥ 2, tiempo deisquemia caliente (WIT) ≤ 25 minutos, ∆GFR posoperatoria ≤ 15 % y márgenes quirúrgicos negativos.Resultados: La edad media fue de 58 años (DE ± 12).La mediana (Q1; Q3) del tamaño del tumor fue de 3,5 (2,2;4,5) cm. De los pacientes tratados, el 33% tenía un tumorventral. El puntaje de nefrometría R.E.N.A.L fue de bajacomplejidad en el 54% de los casos y de alta complejidaden el 4%. La mediana de WIT (Q1; Q3) fue de 20 (14; 23)minutos. La mediana de pérdida de sangre estimada (Q1;Q3) fue de 50 (0; 100) ml. No hubo conversiones a cirugíaabierta. ∆GFR fue >15 % en el 17,5 % de los pacientes.No hubo complicaciones postoperatorias en el 84% de loscasos. No hubo márgenes quirúrgicos positivos. El 68 %de los tumores eran pT1a y el 32 % eran pT1b. El 72% delos pacientes tuvo trifecta. Se encontró una diferencia estadísticamente significativa entre trifecta y tamaño tumoral(3 cm contra 4,4 cm; p˂0,001), complejidad (90% baja contra 56% intermedia; p˂0,0001) y pT (81% T1a contra 53%T1b; p˂0,003).Conclusión: La NPR es una modalidad de tratamientosegura y eficaz para los tumores renales T1a y T1b. La tasatrifecta fue del 72% y se encontró que el tamaño del tumor,la complejidad del tumor y el pT eran factores asociados con trifecta (AU)

Uncommon Glioneuronal Tumors: A Radiologic and Pathologic Synopsis.

Glioneuronal tumors are characterized exclusively by neurocytic elements (neuronal tumors) or a combination of neuronal and glial features (mixed neuronal-glial tumors). Most of these tumors occur in young patients and are related to epilepsy. While ganglioglioma, dysembryoplastic neuroepithelial tumor, and desmoplastic infantile tumor are common glioneuronal tumors, anaplastic ganglioglioma, papillary glioneuronal tumor, rosette-forming glioneuronal tumor, gangliocytoma, and central neurocytoma are less frequent. Advances in immunohistochemical and molecular diagnostics have improved the characterization of these tumors and favored the description of variants and new subtypes, some not yet classified by the World Health Organization. Not infrequently, the histologic findings of biopsies of glioneuronal tumors simulate low-grade glial neoplasms; however, some imaging findings favor the correct diagnosis, making neuroimaging essential for proper management. Therefore, the aim of this review was to present key imaging, histopathology, immunohistochemistry, and molecular findings of glioneuronal tumors and their variants.

Factors influencing gait speed in community-dwelling older women: A Bayesian approach.

BACKGROUND: Human gait is a complex task resulting from the interaction of sensory perception, muscle force output, and sensory-motor integration, which declines with the aging process and impacts gait speed in older women. RESEARCH QUESTION: What are the separate and combined impacts of sensory-motor factors on gait speed of older women? METHODS: Sixty healthy older women (69.3 ±â€¯5.9 years) volunteered for this study. A previous screening using Pearson's correlation selected variables significantly correlated with gait speed: age, plantar tactile perception, lower limb explosive force, and mean velocity (MV) of the center of pressure (CoP). Simple and multivariate regression models were performed with selected variables. The magnitude of evidence was obtained using Bayesian inference, determining posterior probabilities based on our data. RESULTS: Gait speed was negatively correlated with age and positively correlated with plantar tactile perception, MV (Romberg index), and lower limb explosive force. The coefficient of determination (R2) varied between 0.06 for plantar tactile perception and 0.22 for explosive force (p < 0.05). The multivariate model, including age, MV (Romberg index), and lower limb explosive force, explained 44% (R2 = 0.44) of the variance in gait speed, with a small standard error of estimate (0.14 m/s). Bayesian inference confirmed the good posterior probability of the model. SIGNIFICANCE: Age, plantar tactile perception, MV (Romberg index), and lower limb explosive force impact gait speed, whereas the combination of the first three factors has an excellent posterior probability of predicting or affecting gait speed.

Foramen tympanicum prevalence in the population of Southeast Brazil: a morphological study in computed tomography scans.

BACKGROUND: The foramen tympanicum is located on the anteroinferior region of the external acoustic meatus and posteromedial to the temporomandibular joint in children between the 1st and the 5th year of life. It is considered an anatomical variation when it persists in adults. The aim of this study was to verify the prevalence as well as to characterise the foramen tympanicum in computed tomography (CT) scans of the population from southeastern part of Brazil. MATERIALS AND METHODS: A total of 78 CT scans of dry human skulls (20 female and 58 male) were used, which were selected randomly regarding the ages, ranged from 15 to 100 years. The foramen tympanicum was identified in the images of the axial plane and confirmed in the images of the coronal and sagittal planes. The largest diameter (in mm) was obtained. The descriptive statistics (in %), Fisher's test and χ2 test were performed to compare the prevalence of foramen tympanicum between sexes and sides. The probability value ≤ 0.05 was defined as a level of significance. Descriptive statistics were performed to verify the mean diameter of the foramen on the right and left sides of the skulls. RESULTS: The prevalence of foramen tympanicum was higher in females (p = 0.0070), bilaterally, as the absolute values of females were lower in relation to males. Fisher's exact test showed that the prevalence of foramen tympanicum was significantly higher in females (45%) than in males (15.52%). On the right side, the mean axial diameter was 2.23 mm (range 0.93-3.75 mm). On the left side, the mean axial diameter was 2.22 mm (range 0.9-3.61 mm). CONCLUSIONS: The knowledge of anatomical variations is extremely valuable for an accurate diagnosis, treatment plan and prognosis and a thorough preoperative assessment.

Sanitary sewage disinfection with ultraviolet radiation and ultrasound.

Currently, the world is facing a horrible situation due to SARS-CoV-2. Though its RNA was found in wastewater, there are still no studies on RNA contamination detected in sewage. Hence, a possible treatment of sewage is suggested in this work. The disinfection stage is extremely important in the treatment of effluents, minimizing the impacts on the receiving body of water and promoting public health. In this context, the sequential use of ultrasound and ultraviolet radiation, on a bench scale, was investigated as a way to improve the disinfection of anaerobically treated effluents. Two types of treated effluents were tested, by septic tank and anaerobic filter, for which, two ultrasound frequencies, 25 and 40 kHz, and four doses of UV, 3.6; 9.0; 18 and 36 mJ cm-2 were applied. Physicochemical and microbiological parameters were observed for individual and sequential assays. The better quality of the anaerobic filter effluent influenced the performance of both processes, decreasing the concentration of organic load and turbidity, even though a concentration of total coliforms and Escherichia coli occurred in the lowest quality effluent (septic tank). The application of ultrasound has a positive effect on the inactivation of total coliforms and E. coli up to 1.0 log and provides better conditions for ultraviolet radiation to be sequentially applied. The UV radiation applied for the septic tank and the anaerobic filter inactivates 2.5 log for total coliforms and 3.5 log for E. coli, respectively. It is suggested that the disinfection methods applied in this work to inactivate gram-negative bacteria (E. coli) can also be applied to secondary treatment effluents, as well as being better tested for viruses, protozoa, and helminths. Supplementary Information: The online version contains supplementary material available at 10.1007/s13762-021-03764-7.