Autologous Tooth Dentin Graft: A Retrospective Study in Humans.

Background and Objectives: The aim of this study is to evaluate the efficacy of an autologous dentin graft, via extracted teeth that are processed into bacteria-free particulate dentin in a Smart dentin grinder and then grafted immediately into alveolus post extraction or into bone deficiencies. Materials and Methods: Ten healthy, partially edentulous patients with some teeth in the mandible were recruited in the study. After their own teeth were grinded, particulate teeth were placed in empty sockets and bone defects after teeth extractions. Furthermore, after three, six, 12 and 24 months, core samples using a 3 mm trephine were obtained. Results: At three months, the particles of grinded tooth were immersed inside a new connective tissue with a small new bone formation (16.3 ± 1.98). At six months, we observed small particles of dentin integrated in new immature bone, without inflammation in the soft tissue (41.1 ± 0.76). At twelve months, we observed a high amount of bone formation surrounding tooth particles (54.5 ± 0.24), and at twenty-four months, new bone, a big structure of bone, was observed with dentin particles (59.4 ± 1.23), statistically different when compared it with at three months. Conclusions: A particulate dentin graft should be considered as an alternative material for sockets' preservation, split technique, and also for sinus lifting. One of the special characteristics after 24 months of evaluation was the high resorption rate and bone replacement without inflammation. This material could be considered as an acceptable biomaterial for different bone defects due to its osteoinductive and osteoconductive properties.

Differences in the coinfective process of Staphylococcus aureus and Streptococcus agalactiae in bovine mammary epithelial cells infected by Mycobacterium avium subsp. paratuberculosis.

The interactions between Mycobacterium avium subsp. paratuberculosis (MAP) and the causative agents of bovine mastitis are still relatively unknown. Still, it is suspected that they may contribute to the worsening and persistence of mastitis within the mammary epithelial cells. Considering the growing economic implications of paratuberculosis and subclinical mastitis in dairy herds, this study aimed to determine the coinfection interaction between MAP and S. aureus or S. agalactiae in bovine mammary epithelial cells (MAC-T) in an ex-vivo model. For this purpose, internalisation tests of MAP + S. aureus or MAP + S. agalactiae were performed in MAC-T cells for 10, 30 and 120 min. The qPCR was performed to quantify internalised MAP at the time of exposure. Colony-forming units were counted on BHI agar medium for internalised subclinical mastitis bacteria at each time of infection. Viability tests of MAC-T cells, using the lactate dehydrogenase assay, were performed. The results showed that in the MAC-T cells previously infected by MAP and subsequently by S. aureus, there was a rapid internalisation in the first 10 min, maintaining a higher number of internalised bacteria during all exposure times. Regarding MAP + S. agalactiae, there were no changes in the internalisation patterns. The amount of MAP remained constant at all times evaluated, and there was no compromise in the viability of MAC-T cells during the tests. Thus, the results demonstrate the existence of an interaction between MAP + S. aureus, favouring internalisation and being able to contribute to the persistence of subclinical mastitis in dairy herds.

Expression of podoplanin correlates with prognosis in nasopharyngeal carcinoma.

PURPOSE: Podoplanin is a membrane-bound glycoprotein that plays a role in lymphangiogenesis. Several studies suggest a role of podoplanin in head-and-neck cancer. The purpose of the current study was to evaluate the role of podoplanin as a prognostic marker in nasopharyngeal carcinoma. METHODS: In a monocentric retrospective analysis, data of 42 patients with primary diagnosis of nasopharyngeal carcinoma (diagnosed between 2004 and 2017) were examined regarding the relationship between the immunohistochemically analyzed podoplanin expression status and corresponding clinical and oncological parameters. RESULTS: The mean age was 56.6 years. The majority (61.9%) had an advanced tumor stage (T3-T4). The 5-year overall survival was 54%. 33% showed a positive expression of podoplanin. In patients with tumors with podoplanin expression, 5-year overall survival was 15%, while in patients with tumors without podoplanin expression, 5-year overall survival was 75% (p = 0.017, univariate analysis). In multivariate analysis, podoplanin expression was shown to be the only independent prognostic marker for nasopharyngeal carcinoma (p = 0.025). CONCLUSION: This retrospective study shows that podoplanin expression is a potential prognostic marker for nasopharyngeal carcinomas. In the future, clinical use could filter out more aggressive courses and allow therapy escalation in those cases.

Swine cysticercosis and associated risk factors in non-technified pig breeding in semi-arid region of Sergipe state, Brazil.

The aim of this study was to determine the frequency of Taenia solium anti-metacestode antibodies in slaughtered pigs in a semi-arid region of the "Alto Sertão" of Sergipe state, Brazil, and verify the risk factors associated with swine cysticercosis. For this, 230 samples of swine blood from two slaughterhouses were collected and analyzed by indirect ELISA. The pigs came from five non-technical properties in the semi-arid region of the Alto Sertão of Sergipe state. Searches for cysts in the skeletal muscles of the pigs were performed during slaughter. In addition, an epidemiological questionnaire was applied to the pigs' original properties to determine risk factors. Besides that, the official health services database was evaluated for confirmed cases of neurocysticercosis and taeniasis in humans in the last 5 years, living in the studied region. Seropositivity in pigs was 12.6%, with no significant difference between males and females. No cysts were found in the carcasses of the slaughtered pigs. A positive association was found for properties that discharge domestic sewage into the environment, in river or streams, increasing the risk of positivity by 5.72 times. When analyzing the database of official agencies, there were no records of cases of neurocysticercosis or taeniasis in the resident population in the last 5 years. However, there were frequent cases of idiopathic epilepsy. The results demonstrate that study area is endemic for swine cysticercosis and serves as a warning of the possibility of the occurrence of the taeniasis-cysticercosis complex.

[Value of sialendoscopy in German ENT-hospitals in 2016]. / Stellenwert der Sialendoskopie an deutschen HNO-Kliniken im Jahr 2016.

OBJECTIVE: In 2009 a nationwide survey revealed that only 24 % of the German ENT-hospitals performed sialendoscopy. In 2016 the survey was repeated to reevaluate the actual ranking of sialendoscopy in Germany. MATERIAL UND METHODS: Again, the same questionnaire as in 2009 was sent to all German ENT-hospitals. It is a self-developed questionnaire including eleven questions. The results from 2009 and the new results from 2016 were matched with each other. RESULTS: The amount of hospitals performing sialendoscopy doubled and the number of interventions tripled. There were various reasons for denying sialendoscopy. Main reason was a lack of patients. No differences were seen in ambulant vs. inpatient interventions and the duration of sialendoscopy. Preoperative ultrasound was performed in all hospitals. CONCLUSIONS: The survey reveals an increasing number of hospitals performing sialendoscopy and an increasing number of sialendoscopies. Simultaneously, some hospitals alleged a lack of patients. These facts could explain a development of specialized centers for obstructive sialadenitis and sialendoscopy. Meanwhile, further salivary gland diseases are treated with sialendoscopy. The preoperative diagnostic of choice is ultrasound. Sialendoscopy seems to be more and more established in German ENT-hospitals.

Pharyngeal fistulas after total laryngectomy with and without tracheostoma plasty according to Herrmann.

PURPOSE: Pharyngeal fistula (PF) is one of the most common complications after total laryngectomy (TL). The tracheostoma plasty technique according to Herrmann (TPH) represents an alternative surgical technique to shape the tracheostoma. The aim of this study was to determine whether the performance of a TPH affects the incidence of PF after TL. A secondary aim was to identify potential risk factors for the development of PF with regard to TPH. METHODS: Retrospective evaluation of records of 151 consecutive patients at two tertiary care centers with regard to the occurrence and risk factors of PF after TL with and without TPH. RESULTS: 60 patients with TPH and 91 patients without TPH contributed to the results. The overall incidence of PF was 21.2% (32 out of 151). 23.3% (14 out of 60) of patients with TPH and 19.8% (18 of 91) of patients without TPH developed a PF (p = 0.91). Binary logistic regression analysis revealed significant influence of salvage surgery on the risk to develop PF (odds ratio = 2.9; 95% CI 1.16-7.23; p = 0.026). The occurrence of PF was not significantly influenced by any other investigated factors including performance of TPH. CONCLUSIONS: Performance of TPH after TL does not increase the incidence of PF. Thus, TPH can be considered as a safe alternative surgical technique for the shaping of the tracheostoma following TL.

Cochlear implantation using the underwater technique: long-term results.

INTRODUCTION: The opening of the round window and the insertion of the electrode array into the scala tympani during cochlear implant surgery can lead to a pressure shock of the delicate inner ear structures. By filling the tympanic cavity with Ringer Solution during these surgical steps (underwater technique), the hydrostatic pressure of the fluid acts as a smooth pressure stabilizer, avoiding a pressure shock of the inner ear structures. The aim of this retrospective study was to present long-term results of this new method of cochlear implantation in underwater technique. METHODS: Altogether, 47 implantations in 43 patients with residual hearing at the frequencies 250, 500 and 1000 Hz in the unaided preoperative pure tone audiometry were included. A cochlear implantation via round window with a conventional full-length electrode was performed in underwater technique. Changes of residual hearing 7 weeks and 24 months after surgery were analyzed. RESULTS: Overall postimplant hearing preservation 7 weeks after implantation was achieved in 22 ears (47%). Subsequent follow-up was performed on average 24 months after surgery (range 12 months-4.2 years) in all patients. At this late postoperative evaluation, preservation of hearing was recorded in 18 ears (38%). Neither the follow-up time nor the type of electrode had a significant impact on the postoperative hearing loss. CONCLUSION: The underwater technique is an atraumatic cochlear implantation technique with hearing preservation rates comparable to results in literature and a very small hearing preservation decline rate over time even when using full-length CI electrodes.

The Positive Effect of Sialendoscopy with Irrigation Lavage for Sialadenitis without Sialolithiasis or Stenosis.

AIMS: The aim of the study was to evaluate different irrigation solutions during sialendoscopy to reduce complaints caused by sialodochitis. METHODS: The investigators designed and implemented a retrospective study composed of 94 patients with sialodochitis but no sialolithiasis or relevant stenosis of the salivary duct system. Three different irrigations (normal saline, cortisone single-shot, and cortisone) were used. After the sialendoscopy, the patients were asked about the current status of the affected salivary gland, and the quantity and quality of the gland swelling/inflammation over a follow-up period of 11.6 months (6-24 months). RESULTS: At the time of follow-up, 41 patients (43.6%) no longer had any complaints with the salivary gland in question. In 75.5% of the patients, a satisfying result was achieved. In total, only 3 patients needed submandibulectomy in the course of the study due to persistent complaints. The outcome showed no statistical differences between the mean of the 3 groups (p = 0.149). CONCLUSION: Sialendoscopy with flushing/lavage seems to be a good treatment option for patients with sialodochitis lacking sialolithiasis. The results of this study suggest that the type of irrigation used during sialendoscopy seems to be secondary.

Chronic, wireless recordings of large-scale brain activity in freely moving rhesus monkeys.

Advances in techniques for recording large-scale brain activity contribute to both the elucidation of neurophysiological principles and the development of brain-machine interfaces (BMIs). Here we describe a neurophysiological paradigm for performing tethered and wireless large-scale recordings based on movable volumetric three-dimensional (3D) multielectrode implants. This approach allowed us to isolate up to 1,800 neurons (units) per animal and simultaneously record the extracellular activity of close to 500 cortical neurons, distributed across multiple cortical areas, in freely behaving rhesus monkeys. The method is expandable, in principle, to thousands of simultaneously recorded channels. It also allows increased recording longevity (5 consecutive years) and recording of a broad range of behaviors, such as social interactions, and BMI paradigms in freely moving primates. We propose that wireless large-scale recordings could have a profound impact on basic primate neurophysiology research while providing a framework for the development and testing of clinically relevant neuroprostheses.

Performance of the round window soft coupler for the backward stimulation of the cochlea in a temporal bone model.

The round window vibroplasty is a feasible option for the treatment of conductive, sensorineural and mixed hearing loss. Although clinical data suggest a satisfying clinical outcome with various coupling methods, the most efficient coupling technique of the floating mass transducer to the round window is still a matter of debate. For this, a soft silicone-made coupler has been developed recently that aims to ease and optimize the stimulation of the round window membrane of this middle ear implant. We performed a temporal bone study evaluating the performance of the soft coupler compared to the coupling with individually shaped cartilage, perichondrium and the titanium round window coupler with loads up to 20 mN at the unaltered and fully exposed round window niche. The stimulation of the cochlea was measured by the volume velocities of the stapes footplate detected by a laser Doppler vibrometer. The coupling method was computed as significant factor with cartilage and perichondrium allowing for the highest volume velocities followed by the soft and titanium coupler. Exposure of the round window niche allowed for higher volume velocities while the applied load did not significantly affect the results. The soft coupler allows for a good contact to the round window membrane and an effective backward stimulation of the cochlea. Clinical data are mandatory to evaluate performance of this novel coupling method in vivo.

Cross-border surveillance of sheep and goat rabies in Brazil.

Since Brazil has the largest territory in South America and borders 10 other countries, rabies control is strategic to prevent cross-border spread. However, prevention and control of rabies in small ruminants is neglected. The present study evaluated the spatiotemporal distribution and temporal trends of rabies in small ruminants in Brazil between 2005 and 2023. Official data on rabies case notifications and the population density of goats and sheep from the Brazilian states were used. Descriptive epidemiology and temporal analyses of high-risk clusters and trends were conducted. Rabies cases were reported in all states, except for the Federal District, Roraima, Amapá, Amazonas, and Rondônia. In sheep, 174 cases were reported, with an emphasis on Paraná (25.29 %), being highest. There were 64 cases in goats, with a highlight on Bahia (37.50 %) and Maranhão (18.75 %). However, Espírito Santo presented the highest incidence risk (IR) for goats and sheep. The highest peaks in IR occurred in 2005, 2006 and 2013. A temporal trend of decreasing goat cases was observed in northeastern Brazil from 2005 to 2023. In sheep, the Northeast region showed a downward trend in rabies cases. Three high-risk clusters were identified: the primary cluster for goats occurred in 2006, and for sheep, between 2005 and 2013. Rabies in small ruminants occurs across all Brazilian regions, with high-risk areas in the Northeast, Southeast, and South, as well as a risk of cross-border transmission. These findings support animal health authorities in strengthening rabies control for small ruminants and reducing the risk of transboundary spread.

Prevalence and antimicrobial susceptibility of Streptococcus equi isolated from horses in Santa Catarina state, Southern Brazil.

The objective of this study was to determine the prevalence of Streptococcus equi (S. equi subsp equi and S. equi subsp zooepidemicus) in the state of Santa Catarina and evaluate the antimicrobial susceptibility of the isolates. For this, 420 nasal swab samples were collected from randomly selected horses. Isolation and phenotypic characterization of the bacteria were performed by sowing on 5% sheep blood agar, followed by analysis of morphotinctorial characteristics and biochemical analysis. To differentiate the main beta-hemolytic Streptococcus in horses, the fermentation profiles of the sugar's lactose, maltose, sorbitol, and trehalose were used, which were confirmed at the subspecies level by the PCR technique. The antimicrobial susceptibility panel was defined by the disk diffusion method, testing 13 antimicrobials from ten different classes, all regularly used in equine medical clinics, followed by the calculation of the multiple antimicrobial resistance index. Ten strains of S. equi were isolated, with a prevalence of 2.38% (10/420). Of the total positive samples, 3% (3/10) were confirmed as belonging to S. equi subsp equi and 70% (7/10) were confirmed as belonging to S. zooepidemicus. Multidrug resistance was observed in 60% (6/10) of isolates. The antimicrobial with the greatest resistance was clindamycin with 70% (7/10), followed by beta-lactams, with 40% (4/10) resistance to penicillin and 30% (3/10) to ceftiofur. The isolates were 100% (10/10) sensitive to gentamicin, chloramphenicol, levofloxacin, and vancomycin. This was the first study carried out in the state, and based on these data, it can be said that Santa Catarina has a low prevalence of S. equi and the presence of multi-resistant strains of S. equi was confirmed in the equine herd in Santa Catarina.

Spread analysis of glanders in the state of Piauí, northeastern Brazil.

Brazil is strategic in controlling neglected zoonoses, such as glanders, in its territory. Among the Brazilian states, Piauí is a strategic state for the spread of the disease in the country. The present study aimed to evaluate the spatial and temporal distribution of official cases of glanders in Piauí between 2015 and 2022. The glanders cases were located in the municipalities of the north and central-north mesoregions, mainly in Campo Maior, Teresina and Altos. The highest incidence risk (IR) occurred in of Altos (IR = 257.9), Sussuapara (IR = 158.4), and Teresina (IR = 157.7). A primary cluster was formed with a relative risk of 14.88 between 2019 and 2022, encompassing 34 municipalities in the north and central-north regions. In Piauí, glanders is well localized, with the potential for spread across borders. This is the first study demonstrating the distribution of reported cases of glanders in the state of Piauí.

Dirofilaria immitis in dogs from the coastal tourist region of the state of Alagoas, Brazil.

Canine dirofilariasis, caused by Dirofilaria immitis, is prevalent worldwide. However, the frequency of canine infection in the state of Alagoas, Brazil is scarcely unknown. This study aimed to evaluate the frequency of D. immitis infection in dogs from the coastal municipalities of Alagoas and analyze the risk factors associated with the infection. A cross-sectional study was performed using 426 dogs of different breeds and sex distributed across 15 coastal municipalities in the state of Alagoas. Blood samples were collected from each dog and analyzed for circulating microfilariae and free D. immitis antigens. To investigate the risk factors associated with D. immitis infection, we collected information on dog environments using an epidemiological questionnaire. The results revealed that 12.7% of dogs tested positive for D. immitis. Dogs with travel history were 3.52 times more likely to be infected. Thus, infected dogs in the coastal region of Alagoas should be regularly monitored and the public health system should plan strategies to control this zoonotic disease.

Effect of aortic bifurcation geometry on pressure and peak wall stress in abdominal aorta: Fluid-structure interaction study.

BACKGROUND AND OBJECTIVE: Geometry of aorto-iliac bifurcation may affect pressure and wall stress in aorta and thus potentially serve as a predictor of abdominal aortic aneurysm (AAA), similarly to hypertension. METHODS: Effect of aorto-iliac bifurcation geometry was investigated via parametric analysis based on two-way weakly coupled fluid-structure interaction simulations. The arterial wall was modelled as isotropic hyperelastic monolayer, and non-Newtonian behaviour was introduced for the fluid. Realistic boundary conditions of the pulsatile blood flow were used on the basis of experiments in literature and their time shift was tailored to the pulse wave velocity in the model to obtain physiological wave shapes. Eighteen idealized and one patient-specific geometries of human aortic tree with common iliac and renal arteries were considered with different angles between abdominal aorta (AA) and both iliac arteries and different area ratios (AR) of iliac and aortic luminal cross sections. RESULTS: Peak wall stress (PWS) and systolic blood pressure (SBP) were insensitive to the aorto-iliac angles but sensitive to the AR: when AR decreased by 50%, the PWS and SBP increased by up to 18.4% and 18.8%, respectively. CONCLUSIONS: Lower AR (as a result of the iliac stenosis or aging), rather than the aorto-iliac angles increases the BP in the AA and may be thus a risk factor for the AAA development.

Associations of Usual and Fast Gait Speed With Physical Performance and Balance Confidence in Community-Dwelling Older Adults: Implications for Assessment.

BACKGROUND AND PURPOSE: Gait speed is a robust measure that offers many advantages clinically. However, decisions concerning its utilization exist, including whether to assess usual or fast gait speed. The current study aimed to identify whether usual or fast gait speed was more strongly associated with physical performance measures and balance confidence. A secondary aim was to explore these relationships within subgroups based on fall risk status. METHODS: This was an observational study with a cross-sectional design involving 57 community-dwelling older adults (77.2% female; mean age = 68.8, SD = 6.5 years, range = 60-87 years) who were assessed on the following variables: usual and fast gait speed, knee extension strength, step execution time, 6-minute walk test (6MWT), and Activities-specific Balance Confidence Scale (ABC-6). Spearman ρ correlations were computed to determine bivariate associations of usual and fast gait speed with physical performance measures and balance confidence for the whole sample and within subgroups based on fall risk [lower fall risk (n = 28) vs higher fall risk (n = 29)]. Multiple linear regression models were estimated with either usual or fast gait speed as key predictors of knee extension strength, step execution time, 6MWT, and ABC-6. RESULTS AND DISCUSSION: Stronger correlations were observed for fast gait speed compared with usual gait speed with all physical performance measures and balance confidence for the entire sample and within the higher fall risk group. Multiple regression results indicated that models with fast rather than usual gait speed as the key predictor explained more of the variance in 6MWT (R2 = 64.5% vs 45.6%), ABC-6 (R2 = 28.5% vs 25.4%), step execution time (R2 = 24.9% vs 19.0%), and knee extension strength (R2 = 15.7% vs 7.2%). CONCLUSIONS: Fast gait speed showed stronger associations and better predictive capabilities compared with usual gait speed with physical performance measures and balance confidence in older adults. Despite being measured less often than usual gait speed, fast gait speed assessment warrants additional consideration.

Methodology for estimation of undeformed thickness of arterial tissues.

Soft tissue sample thickness measurement is one of the major sources of differences between mechanical responses published by different groups. New method for the estimation of unloaded sample thickness of soft tissues is proposed in this study. Ten 30 × 30 mm and ten 20 × 20 mm samples of porcine anterior thoracic aortas were loaded by gradually increased radial force. Their deformed thickness was then recorded in order to generate a pressure-thickness response. Next, the limit pressure to which the response can be considered linear was estimated. Line was fitted to the linear part of the curve and extrapolated towards zero pressure to estimate unloaded thickness (7 kPa fit). For comparison, data near zero pressure were fitted separately and extrapolated towards zero (Near Zero fit). The limit pressure for the linearity of the response was around 7 kPa. The Unloaded thickness for 30 × 30 mm samples was 2.68 ± 0.31 mm and 2.68 ± 0.3 mm for Near Zero fit and 7 kPa fit, respectively. The Unloaded thickness for 20 × 20 mm samples was 2.60 ± 0.35 mm and 2.59 ± 0.35 mm for Near Zero fit and 7 kPa fit, respectively. The median of thickness difference between smaller and larger samples was not found statistically different. Proposed method can estimate unloaded undeformed sample thickness quickly and reliably.

Analgesia after tonsillectomy with controlled intravenous morphine - overdue or exaggerated?

OBJECTIVE: To assess the value of a morphine Patient Controlled Intravenous Analgesia (PCIA) after Tonsillectomies (TE). METHODS: 30 adult patients were treated with oral analgesics (protocol group) and compared to 30 patients treated with a morphine PCIA for the first 3 Postoperative Days (PODs) after TE. Average and maximum pain severities (Numeric Rating Scale - NRS: 0-10) on PODs 1-3, analgesic score, quality of life, patient satisfaction and side effects were defined as outcome measures. RESULTS: Average pain severities of the protocol and the PCIA group were of similar magnitude (NRS) (POD1: 4.48 vs. 4.71 [p = 0.68], POD2: 4.75 vs. 4.22 [p = 0.32] and POD3: 4.44 vs. 4.25 [p = 0.71]). Maximum pain intensities on POD1 (p = 0.92), POD2 (p = 0.51) and POD3 (p = 0.36) were also comparable between both groups. Patients with a PCIA consumed significantly more opioids (p = 0.001) without significant more side-effects. CONCLUSION: The PCIA did not provide a superior pain control compared to oral analgesics. In view of the considerable effort and the high opioid consumption, it cannot be recommended as a standardized application for pain control after TE.

A systematic review of the microbial community in taiassuids: a One Health approach.

Collared and white-lipped peccaries are sympatric and are distributed in most of South America and in the humid tropical forests of Mexico and Central America. Historically, these species have been used as a source of protein by traditional and/or indigenous human communities, but currently they have been used for legal consumption in different countries. Thus, there has been greater interaction between these wild species and domestic animals and humans, enabling microbial interactions between different niches. The present study presents a systematic review of the literature on the microbial community of collared peccaries and white-lipped peccaries distributed throughout the world, focusing on experimental studies related to the detection of microorganisms as well as the prevalence of the animal species and its characterization of the studied population, in situ or ex situ. Seventy-two studies were selected, mainly in South American countries, related to different species of microorganisms isolated or serologically detected (viruses, bacteria, fungi, and parasites), either as microbiota, pathogens or commensals, many of which are of zoonotic interest, such as Leptospira, Toxoplasma, Brucella, among others. Therefore, these wild mammals are characterized as sentinel agents of anthropic action and require the implementation of studies in relation to their contribution to the spread of microorganisms, being a potential source of amplification and transmission of pathogens.