Survival rate of teeth adjacent and nonadjacent to dental implants: A retrospective cohort study.

BACKGROUND: The aim of this retrospective study was to investigate the risk of tooth loss for teeth adjacent and nonadjacent to dental implants. METHODS: A total of 787 patients with an average follow-up of 57.1 months were examined to define the tooth loss, cumulative survival rate, and odds ratio (OR) for teeth adjacent versus nonadjacent to implants. A multivariate logistic regression was employed to assess the association between dental history and various recorded etiologies of tooth loss among teeth adjacent to implants. RESULTS: The incidence of tooth loss for teeth adjacent to implants was 8.1% at the tooth level and 15.1% at the patient level, while 0.7% and 9.5% at the tooth and patientlevel for teeth nonadjacent to implants. The 10-year cumulative survival rate for teeth adjacent to implants was 89.2%, and the primary etiology of tooth loss was root fracture (45.2%). The risk of tooth loss among teeth adjacent versus nonadjacent to implants was significantly higher (OR 13.15). Among teeth adjacent to implants, root canal-treated teeth had a significantly higher risk of tooth loss due to root fracture (OR 7.72), a history of existing restoration significantly increased the risk of tooth loss due to caries (OR 3.05), and a history of periodontitis significantly increased the risk of tooth loss due to periodontitis (OR 38.24). CONCLUSION: The present study demonstrated that after patients received dental implant treatment, teeth adjacent to implants showed a 13.2-fold higher risk of tooth loss compared to teeth nonadjacent to implants, with the primary etiology being root fracture.

The Effect of Anti-Depressants on Dental Implant Failure: A Systematic Review and Meta-Analysis.

PURPOSE: The aim of this systematic review and meta-analysis is to analyze the risk of dental implant failure for patients who had a history of anti-depressant use. MATERIALS AND METHODS: An electronic search was performed up to June 2023 in three databases, including PubMed/MEDLINE, Web of Science and Cochrane Central Register of Controlled Trials with data on comparison of implant failure rate for patients with and without the use of antidepressants were included. Meta-analyses for the risk ratio of implant failure rate at the patient level and implant level were performed. RESULTS: Eleven clinical studies were selected for inclusion in this review. The meta-analyses showed a risk ratio of 2.44 (95% confidence interval= 1.75 to 3.39, p< 0.0001) and 2.44 (95% CI= 1.73 to 3.46, p< 0.0001) for the implant failure at the patient level and implant level, respectively. The comparisons presented a low heterogeneity for the patient-level analysis and a moderate heterogeneity for the implant-level analysis among the pooled studies. Subgroup analyses also revealed that patients who received only selective serotonin reuptake inhibitors (SSRIs) or SSRIs with other type of anti-depressants had a higher risk of implant failure than those who were not on any anti-depressants. CONCLUSIONS: The current review demonstrates the use of anti-depressants, such as SSRIs, may increase the risk of dental implant failure at both patient level and implant level. Although limited evidence suggests that a certain type of SSRI (sertraline) may have more influence on implant failure than other SSRIs, future studies are needed to warrant this finding.

Application of Business Intelligence in Decision Support to Hospital Management: An Example of Outpatient Clinic Schedule Arrangement.

There is a gap between medical resources and patient needs, Managers need to obtain productivity information to optimize resources allocation. The value of this research is that the information provided by the dashboard allows hospital managers problems respond to it quickly. We recommend the research could integrate more data (such as temperature data, national death population data record), so as to be closed to hospital operating cost control and to estimate patients' needs.

Severe acute kidney disease is associated with worse kidney outcome among acute kidney injury patients.

Acute kidney disease (AKD) comprises acute kidney injury (AKI). However, whether the AKD staging system has prognostic values among AKI patients with different baseline estimated glomerular filtration (eGFR) remains a controversial issue. Algorithm-based approach was applied to identify AKI occurrence and to define different AKD stages. Risk ratio for major adverse kidney events (MAKE), including (1) eGFR decline > 35% from baseline, (2) initiation of dialysis, (3) in-hospital mortality of different AKD subgroups were identified by multivariable logistic regression. Among the 4741 AKI patients identified from January 2015 to December 2018, AKD stages 1-3 after AKI was common (53% in the lower baseline eGFR group and 51% in the higher baseline eGFR group). In the logistic regression model adjusted for demographics and comorbidities at 1-year follow-up, AKD stages 1/2/3 (AKD stage 0 as reference group) were associated with higher risks of MAKE (AKD stage: odds ratio, 95% confidence interval [95% CI], AKD 1: 1.85, 1.56-2.19; AKD 2: 3.43, 2.85-4.12; AKD 3: 10.41, 8.68-12.49). Regardless of baseline eGFR, staging criteria for AKD identified AKI patients who were at higher risk of kidney function decline, dialysis and mortality. Post-AKI AKD patients with severer stage need intensified care and timely intervention.

Management of Recurrent Gummy Smile After 7 Years: A Case Report.

Esthetic crown lengthening is a periodontal surgical procedure to correct excess gingival display (ie, "gummy smile"). The procedure may require soft-tissue excision only, osseous resection, or a combination of both. However, the long-term healing responses, such as soft-tissue relapse or recession and hard-tissue regrowth and resorption, have not been fully reported in the literature. This case report describes the management of a patient with esthetic concerns about a gummy smile. The patient stated that the maxillary anterior area had been previously treated with periodontal surgery 7 years earlier but the condition had slowly recurred over time. The authors highlight the possible reasons for the recurrence and the keys to successfully managing the case.

Effects on Ridge Dimensions, Bone Density, and Implant Primary Stability with Osseodensification Approach in Implant Osteotomy Preparation.

PURPOSE: To compare the amount of bone expansion, bone density change, and implant primary stability with an osseodensification technique to a conventional drilling protocol. MATERIALS AND METHODS: Twenty-four bovine rib segments (20 × 25 × 4 mm) with a 1-mm outer layer of cortical bone were randomly divided into two groups: an osseodensification group and a conventional drilling group. Each bone sample received one 4.1 × 10-mm implant. The density of the peri-implant bone before and after osteotomy was measured. After implant placement, primary stability was assessed. A laser surface scanner was used before and after implant placement to compare the dimension of crestal bone width and volumetric expansion. Histomorphometric analysis was performed to compare the bone-to-implant contact percentage (BIC%) of the two groups. RESULTS: The peripheral and apical bone mineral density around the implants was significantly increased, and a statistically significantly higher peripheral BIC% was found in the osseodensification group. A significant increase in volume and bone width after implant placement was found in both groups. However, there were no significant differences in volume and bone width change at all three locations and in implant stability between the osseodensification and conventional drilling protocols. CONCLUSION: Within the limitations of this study, the osseodensification protocol increased the bone mineral density and primary bone-to-implant contact. Also, this study suggests that implant placement by osseodensification or conventional drilling can increase ridge dimensions in narrow alveolar ridges.

Insidious presentation of intussusception with appendicitis.

Intussusception in relation to appendicitis is an uncommon occurrence and is rarely described in the literature. We describe a case of diagnostic uncertainty and finding of ileocolic intussusception associated with appendicitis in a 22-year-old male. The patient presented with a history of acute right-sided abdominal pain. He underwent a computed tomography scan showing ileocolic intussusception following an operation with the finding of an inflamed appendix, which was likely to have served as a mechanical lead point of the intussusception. Due to the presence of ischaemia of the right colon, he underwent a right hemicolectomy.

Cryptanshinone Inhibits the Glycolysis and Inhibits Cell Migration Through PKM2/ß-Catenin Axis in Breast Cancer.

BACKGROUND: Breast cancer is one of the most prevalent gynecologic malignancies worldwide. Despite the high sensitivity in response to chemotherapy, drug resistance occurred frequently in clinical treatment. Cryptotanshinone (CTS) is a herbal medicine and has been identified as an anti-inflammatory and anti-oxidative drug. METHODS: In vitro assays, including the cell proliferation assay, colony formation assay, Western blot analysis, transwell migration/invasion assays, and cell scratch assay were used to explore the biological activities and working mechanism of CTS. Breast cancer cells were also transfected with PKM2 expressing vectors to define the molecular mechanisms involved in CTS-mediated anti-tumor activity. RESULTS: We found that CTS shows anti-proliferative effects and decreases the clonogenic ability of breast cancer cells. We also found that CTS inhibited the migration and invasion activity of MCF-7 and MDA-MB-231 cells by different analyzed methods. CTS also downregulated the levels of glycolysis-related proteins, such as PKM2, LDHA, and HK2. In addition, overexpression of PKM2 recovered CTS-mediated suppression of cell proliferation, colony formation, and cell mobility of breast cancer cells. We also found PKM2 was significantly overexpressed in tumor tissues and invasive ductal breast carcinoma compared to normal tissues and patients with high PKM2 expression had worse overall survival and metastasis-free survival outcomes. CONCLUSION: CTS inhibited the proliferation, migration, and invasion of breast cancer cells. The involved mechanism may refer to the downregulation of the PKM2/ß-catenin axis.

Amnion-Chorion Allograft Barrier Used on Root Surface for Regenerative Procedures: Case Report.

INTRODUCTION: Guided tissue regeneration (GTR) has been well documented with combination of bone graft substitutes and biologic modifiers to improve the outcomes of periodontal regenerative procedures. Amnion-chorion allograft membrane (ACM) is a placenta-derived resorbable allograft membrane which contains growth factors found in the placenta. The primary purpose of the barrier membranes for GTR was to exclude the epithelial down-growth along with the root surface, however, the ACM can be used as an additional biologic modifier because of the release of growth factors from the ACM after placement. The aim of this case report is to evaluate the efficacy and the application of ACM on the previously diseased root surface to treat periodontal intrabony defect. CASE PRESENTATION: A 60-year-old Caucasian male with deep and wide intrabony defect on mesial #19 was treated with a regenerative procedure with combination of application of ACM on the root surface and filling the intrabony defect with the corticocancellous freeze-dried bone allograft. The bone substitute was covered with another layer of ACM and primary closure was achieved. Wound healing process was uneventful, and the clinical and radiographic outcomes were favorable up to 18 months after the surgical procedure. CONCLUSION: This case report demonstrated that the application of ACM on the root surface with a combination of bone substitute might enhance to the radiographic bone fill and the clinical attachment level gain and minimize the risk of post-operative gingival recession.

Histology of ex vivo skin after treatment with fractionated picosecond Nd:YAG laser in high and low-energy settings.

Background: The fractionated picosecond laser produces microscopic lesions in the epidermis and dermis, which are known as laser-induced optical breakdown (LIOB) and intra-dermal laser-induced cavitation (LIC). There have been multiple histological reports on these phenomena, although some have been challenged on the grounds of similarity to artifacts. Asian skins, with a higher melanin content, may react differently to this treatment, and present literature is also lacking in this area.Purpose: To observe and report the histological effect of different energy levels and parameters of the fractional 532 nm/1064 nm picosecond laser on Asian skin ex vivo.Methods: Six skin samples were taken from clinically normal-looking perilesional areas and treated with different energy levels and parameters of the fractional 532 nm/1064 nm picosecond laser. The specimens were then sent to the lab for H&E staining, and the slides were reviewed by a dermatopathologist.Results: Superficial, intra-epidermal LIOBs were seen in skin treating at higher laser energies; deep, intra-dermal LICs were seen in skin treated at lower energies. Lesion sizes and depths were consistent with previously reported values on Caucasian skins, and lesions were spaced in 600-µm intervals or its multiple.Conclusions: The histological findings are consistent with results from other ethnicities, and the spacing of lesions is a strong indication of their validity as LIOBs or LICs.

Cloud Computing for Infectious Disease Surveillance and Control: Development and Evaluation of a Hospital Automated Laboratory Reporting System.

BACKGROUND: Outbreaks of several serious infectious diseases have occurred in recent years. In response, to mitigate public health risks, countries worldwide have dedicated efforts to establish an information system for effective disease monitoring, risk assessment, and early warning management for international disease outbreaks. A cloud computing framework can effectively provide the required hardware resources and information access and exchange to conveniently connect information related to infectious diseases and develop a cross-system surveillance and control system for infectious diseases. OBJECTIVE: The objective of our study was to develop a Hospital Automated Laboratory Reporting (HALR) system based on such a framework and evaluate its effectiveness. METHODS: We collected data for 6 months and analyzed the cases reported within this period by the HALR and the Web-based Notifiable Disease Reporting (WebNDR) systems. Furthermore, system evaluation indicators were gathered, including those evaluating sensitivity and specificity. RESULTS: The HALR system reported 15 pathogens and 5174 cases, and the WebNDR system reported 34 cases. In a comparison of the two systems, sensitivity was 100% and specificity varied according to the reported pathogens. In particular, the specificity for Streptococcus pneumoniae, Mycobacterium tuberculosis complex, and hepatitis C virus were 99.8%, 96.6%, and 97.4%, respectively. However, the specificity for influenza virus and hepatitis B virus were only 79.9% and 47.1%, respectively. After the reported data were integrated with patients' diagnostic results in their electronic medical records (EMRs), the specificity for influenza virus and hepatitis B virus increased to 89.2% and 99.1%, respectively. CONCLUSIONS: The HALR system can provide early reporting of specified pathogens according to test results, allowing for early detection of outbreaks and providing trends in infectious disease data. The results of this study show that the sensitivity and specificity of early disease detection can be increased by integrating the reported data in the HALR system with the cases' clinical information (eg, diagnostic results) in EMRs, thereby enhancing the control and prevention of infectious diseases.

Literature review of the adverse events associated with botulinum toxin injection for the masseter muscle hypertrophy.

BACKGROUND: Masseteric hypertrophy is a benign condition characterized by the enlargement of the masseter muscles. A square-shaped jawline due to masseter muscle prominence or hypertrophy is one of the general characteristics of the Asian face, making it a frequent target for esthetic treatment requests. While the application of botulinum toxin on the masseter muscle is an off-label use, it is very popular in Asian countries. However, comprehensive reviews of the complications associated with this procedure remain limited in scope. OBJECTIVES: The goal of this study is to help physicians achieve a comprehensive understanding of the complications associated with neuromodulator injection over the masseter muscle via a thorough literature review. METHODS: A literature search was performed on the PubMed/MEDLINE, Google Scholar, and Science Direct databases using the search terms botulinum toxin, masseter hypertrophy, masseteric hypertrophy, and/or masseter hyperplasia. Literature from January 1994 to February 2018 was deemed to be allegeable for inclusion and analysis. All available prospective and retrospective studies, case series, case reports, and expert reviews were included, with an emphasis on types of complications, incidence rate, onset time, recovery time, and product used. Articles that do not mention side effects, complications, or adverse events were excluded. RESULTS: Thirty-six articles were found, covering type, incidence rate, and clinical course of the complications. These studies were summarized into tabular form for easy reference and comparison. CONCLUSION: Botulinum toxin masseter injections are commonly performed procedures with good results and safety profiles. The majority of complications appeared within 2-4 weeks of injection and disappeared within 12 weeks. Despite the temporary nature of these complications, they often decrease patient satisfaction and confidence, so physicians should familiarize themselves with the regional anatomy and injection safety zones.

Intelligent prescription system combined with a national pharmacloud for geriatrics care.

INTRODUCTION: The elderly are high risk for chronic diseases and multiple drug use - two problems that make geriatric medication use more complex; as a result, the possibility of duplicate prescriptions and drug interactions increase, affecting patient safety. The objective of this study was to develop an Intelligent Prescription System Combined with a National PharmaCloud for Geriatrics Care (IPSPcG) that can reduce the occurrence of duplicate prescriptions. METHODS: The system was implemented in a teaching hospital in Taiwan. The IPSPcG consists of two major components: (1) the collection module and (2) Intelligent Knowledge-base Module. Data on medication prescription behaviors and medication-blocking rates were gathered from January 2015 to December 2017. RESULTS: Overall, during the study period, the IPSPcG system included 39,678 prescriptions. Antihypertensive medications were included at the highest proportion (8962, 22.6%). The system changed physician's prescription behavior (p < .001) and decreased potential duplicate prescription times (14%). CONCLUSION: The results of this study show that integrating appropriate recommendations from drug messages can reduce repeated drug prescriptions. Due to the diversity of diseases, the diversity and accuracy of medical advice must improve. The results of the 'Comprehensive Prescription Information' provided by this system can serve as a reference for future research.

Lamellae Assembly in Dendritic Spherulites of Poly(l-lactic Acid) Crystallized with Poly(p-Vinyl Phenol).

Lamellar assembly with fractal-patterned growth into dendritic and ringed spherulites of crystallized poly(l-lactic acid) (PLLA), of two molecular weight (MW) grades and crystallized at (temperature of crystallization) Tc = 120 and 130 °C, respectively, are evaluated using optical and atomic-force microscopies. The results of surface-relief patterns in correlation with interior microscopy analyses in this work strongly indicate that the observed birefringence changes in PLLA polymer dendritic or ringed spherulites (from blue to orange, or to optical extinction) need not be definitely associated with the continuous helix twisting of lamellae; they can be caused by sudden and discontinuous lamellae branching at intersected angles with respect to the original main lamellae, as proven in the case of dendritic and zig-zag rough-ringed spherulites. Intersection angles between the main stalks and branches tend to be governed by polymer crystal lattices; for PLLA, the orthorhombic lattice (α-form) usually gives a 60° angle of branching and hexagonal growth. The branching lamellae then further bend to convex or concave shapes and finally make a 60⁻90° angle with respect to the main stalks. Such mechanisms are proven to exist in the straight dendritic/striped high-molecular weight (HMW)-PLLA spherulites (Tc = 120 °C); similar mechanisms also work in circularly ringed (Tc = 130 °C) HMW-PLLA spherulites.

Influence of Oxygen Vacancies on the Frictional Properties of Nanocrystalline Zinc Oxide Thin Films in Ambient Conditions.

Oxygen vacancy is the most studied point defect and has been found to significantly influence the physical properties of zinc oxide (ZnO). By using atomic force microscopy (AFM), we show that the frictional properties on the ZnO surface at the nanoscale greatly depend on the amount of oxygen vacancies present in the surface layer and the ambient humidity. The photocatalytic effect (PCE) is used to qualitatively control the amount of oxygen vacancies in the surface layer of ZnO and reversibly switch the surface wettability between hydrophobic and superhydrophilic states. Because oxygen vacancies in the ZnO surface can attract ambient water molecules, during the AFM friction measurement, water meniscus can form between the asperities at the AFM tip-ZnO contact due to the capillary condensation, leading to negative dependence of friction on the logarithm of tip sliding velocity. Such dependence is found to be a strong function of relative humidity and can be reversibly manipulated by the PCE. Our results indicate that it is possible to control the frictional properties of ZnO surface at the nanoscale using optical approaches.

Critical evaluation of contemporary management in a new Pelvic Exenteration Unit: The first 25 consecutive cases.

AIM: To critically appraise short-term outcomes in patients treated in a new Pelvic Exenteration (PE) Unit. METHODS: This retrospective observational study was conducted by analysing prospectively collected data for the first 25 patients (16 males, 9 females) who underwent PE for advanced pelvic tumours in our PE Unit between January 2012 and October 2016. Data evaluated included age, co-morbidities, American Society of Anesthesiologists (ASA) score, Eastern Cooperative Oncology Group (ECOG) status, preoperative adjuvant treatment, intra-operative blood loss, procedural duration, perioperative adverse event, lengths of intensive care unit (ICU) stay and hospital stay, and oncological outcome. Quantitative data were summarized as percentage or median and range, and statistically assessed by the χ2 test or Fisher's exact test, as applicable. RESULTS: All 25 patients received comprehensive preoperative assessment via our dedicated multidisciplinary team approach. Long-course neoadjuvant chemoradiotherapy was provided, if indicated. The median age of the patients was 61.9-year-old. The median ASA and ECOG scores were 2 and 0, respectively. The indications for PE were locally invasive rectal adenocarcinoma (n = 13), advanced colonic adenocarcinoma (n = 5), recurrent cervical carcinoma (n = 3) and malignant sacral chordoma (n = 3). The procedures comprised 10 total PEs, 4 anterior PEs, 7 posterior PEs and 4 isolated lateral PEs. The median follow-up period was 17.6 mo. The median operative time was 11.5 h. The median volume of blood loss was 3306 mL, and the median volume of red cell transfusion was 1475 mL. The median lengths of ICU stay and of hospital stay were 1 d and 21 d, respectively. There was no case of mortality related to surgery. There were a total of 20 surgical morbidities, which occurred in 12 patients. The majority of the complications were grade 2 Clavien-Dindo. Only 2 patients experienced grade 3 Clavien-Dindo complications, and both required procedural interventions. One patient experienced grade 4a Clavien-Dindo complication, requiring temporary renal dialysis without long-term disability. The R0 resection rate was 64%. There were 7 post-exenteration recurrences during the follow-up period. No statistically significant relationship was found among histological origin of tumour, microscopic resection margin status and postoperative recurrence (P = 0.67). Four patients died from sequelae of recurrent disease during follow-up. CONCLUSION: By utilizing modern assessment and surgical techniques, our PE Unit can manage complex pelvic cancers with acceptable morbidities, zero-rate mortality and equivalent oncologic outcomes.

Development of Day Care Management Systems for Elderly.

The purpose of this study is to build a practical, highly efficient management information system (MIS) for elderly day care (EDC) centers to improve elders' lives. Based on system requirements and the management operation guidelines for EDC, we have developed an MIS. The introduction of the system will help EDC management to be more accurate, comprehensive, and efficient.

Pelvic autonomic nerve preservation in radical rectal cancer surgery: changes in the past 3 decades.

The advent of total mesorectal excision (TME) together with minimally invasive techniques such as laparoscopic colorectal surgery and robotic surgery has improved surgical results. However, the incidence of bladder and sexual dysfunction remains high. This may be particularly distressing for the patient and troublesome to manage for the surgeon when it does occur. The increased use of neoadjuvant and adjuvant radiotherapy is also associated with poorer functional outcomes. In this review, we evaluate current understanding of the anatomy of pelvic nerves which are divided into the areas of the inferior mesenteric artery pedicle, the lateral pelvic wall and dissection around the urogenital organs. Surgical techniques in these areas are discussed. We also discuss the results in functional outcomes of the various techniques including open, laparoscopic and robotic over the last 30 years.

Spongiibacter taiwanensis sp. nov., a marine bacterium isolated from aged seawater.

A Gram-reaction-negative, heterotrophic, marine bacterium, designated strain SPT1T, was isolated from an aged seawater sample which was collected from the shallow coastal region of Nanya, Keelung, Taiwan and stored at room temperature for more than 7 years. Strain SPT1T was a motile rod which exhibited monotrichous flagellation. It required NaCl for growth and exhibited optimal growth at 30-35 °C, 1-3 % NaCl and pH 7-8. The strain was a strictly aerobic bacterium, incapable of anaerobic growth by nitrate reduction or denitrification, or by fermenting glucose or other carbohydrates. Cellular fatty acids were dominated by C16 : 1ω7c and/or C16 : 1ω6c (23.4 %), C17 : 1ω8c (18.1 %), C16 : 0 (8.5 %), C18 : 1ω7c (8.4 %) and C10 : 0 3-OH (6.3 %). The predominant isoprenoid quinone was Q-8. Polar lipids consisted of phosphatidylethanolamine, phosphatidylglycerol and phosphatidic acid. The DNA G+C content was 57.9 mol%. Phylogeny based on 16S rRNA gene sequences showed that strain SPT1T formed a distinct species-level lineage within the genus Spongiibacter of the class Gammaproteobacteria and shared sequence similarities of 94.4-96.2 % with Spongiibacter marinusand Spongiibacter tropicus, the only two species of the genus Spongiibacterwith validly published names. The 16S rRNA gene sequence similarities between strain SPT1T and other species were less than 93.1 %. Polyphasic taxonomic data obtained in this study indicated that strain SPT1T could be classified as a novel species of the genus Spongiibacter, for which the name Spongiibacter taiwanensis sp. nov. is proposed. The type strain is SPT1T (=JCM 31012T=BCRC 80916T).