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1.
ACS EST Air ; 1(9): 973-988, 2024 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-39295746

RESUMO

In Houston, Texas, nitrogen dioxide (NO2) air pollution disproportionately affects Black, Latinx, and Asian communities, and high ozone (O3) days are frequent. There is limited knowledge of how NO2 inequalities vary in urban air quality contexts, in part from the lack of time-varying neighborhood-level NO2 measurements. First, we demonstrate that daily TROPOspheric Monitoring Instrument (TROPOMI) NO2 tropospheric vertical column densities (TVCDs) resolve a major portion of census tract-scale NO2 inequalities in Houston, comparing NO2 inequalities based on TROPOMI TVCDs and spatiotemporally coincident airborne remote sensing (250 m × 560 m) from the NASA TRacking Aerosol Convection ExpeRiment-Air Quality (TRACER-AQ). We further evaluate the application of daily TROPOMI TVCDs to census tract-scale NO2 inequalities (May 2018-November 2022). This includes explaining differences between mean daily NO2 inequalities and those based on TVCDs oversampled to 0.01° × 0.01° and showing daily NO2 column-surface relationships weaken as a function of observation separation distance. Second, census tract-scale NO2 inequalities, city-wide high O3, and mesoscale airflows are found to covary using principal component and cluster analysis. A generalized additive model of O3 mixing ratios versus NO2 inequalities reproduces established nonlinear relationships between O3 production and NO2 concentrations, providing observational evidence that neighborhood-level NO2 inequalities and O3 are coupled. Consequently, emissions controls specifically in Black, Latinx, and Asian communities will have co-benefits, reducing both NO2 disparities and high O3 days city wide.

2.
Am J Epidemiol ; 2024 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-39317692

RESUMO

Current methods for identifying temporal windows of effect for time-varying exposures in omics settings can control false discovery rates at the biomarker-level but cannot efficiently screen for timing-specific effects in high dimensions. Current approaches leverage separate models for site screening and identification of susceptible time windows, which miss associations that vary over time. We introduce the epigenome-wide distributed lag model (EWDLM), a novel approach that combines traditional false discovery rate methods with the distributed lag model (DLM) to screen for timing-specific effects in high dimensional settings. This is accomplished by marginalizing DLM effect estimates over time and correcting for multiple comparisons. In a simulation investigating timing-specific effects of ambient air pollution during pregnancy on DNA methylation across the epigenome at age 12 years, EWDLM achieved an increased sensitivity for associations limited to specific periods of time compared to traditional two-stage approaches. In a real-world EWDLM analysis, 353 CpG sites at which DNAm measured at age 12 was significantly associated with PM2.5 exposure during pregnancy were identified. EWDLM is a novel method that provides an efficient and sensitive way to screen epigenomic datasets for associations with exposures localized to specific time periods.

3.
Int J Environ Health Res ; : 1-15, 2024 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-39166712

RESUMO

Green exercise, defined as physical activity in natural settings, shows promise for enhancing exercise participation and improving health. This systematic review aimed to assess the effectiveness of green exercise in people with chronic conditions. Seven electronic databases were searched and of the 7801 screened articles, 14 trials met the inclusion criteria. Green exercise was a safe and well-tolerated intervention, with low drop-out levels. It was found to positively affect participants' quality of life in three studies and mental health in four studies. Compared to non-exercise groups, green exercise significantly improved physical and mental health in patients with breast cancer, COPD, cardiovascular disease risk, chronic low back pain, obesity, and diabetes. However, it had no impact on the physical health of stroke patients or the cognitive performance of those with ADHD. Green exercise appears to be a safe intervention that can improve various chronic health issues.

4.
Sci Total Environ ; 949: 174986, 2024 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-39053556

RESUMO

The importance of understanding the long-lasting legacy of past land use on modern ecosystems has long been acknowledged. However, the magnitude and persistence of such legacies have been assessed only occasionally. Northern Greece has been a gateway of farming into mainland Europe during the Neolithic, thus providing a perfect setting to assess the potential impact of land-use history on present-day ecosystems. Additionally, the marked Holocene climatic variability of the southern Balkans makes it possible to investigate climate-vegetation-land use interactions over long timescales. Here, we have studied a sediment record from Limni Vegoritis (Northern Greece) spanning the past ∼9000 years using palaeoecological proxies (pollen, spores, stomata, microscopic charcoal). We aimed to reconstruct long-term vegetation dynamics in submediterranean Greece, to assess the environmental factors controlling them and to establish the legacies of the long history of land use in the modern landscape. We found that the Early Holocene afforestation, mainly oak woodlands, was delayed because of suboptimal moisture conditions. Later, colder and drier conditions during the rapid climate change centred around the '8.2 ka event' triggered woodland opening and the spread of wooded (Juniperus) steppe vegetation. First indicators of farming activities are recorded during this period, but their abundances are too low to explain the concurrent large deforestation episode. Later, pinewoods (probably dominated by Pinus nigra) with deciduous Quercus spread and dominated the landscape for several millennia. These forests experienced repeated multi-centennial setback-recovery episodes associated with land-use intensification, but pines eventually declined ∼2500-2000 years ago during Classical times under heavy land use comprising intense pastoralism. This was the starting point for the present-day landscape, where the main 'foundation' taxon of the ancient forests (Pinus cf. nigra) is missing, therefore attesting to the strong imprint that historical land use has left on the modern landscape.


Assuntos
Agricultura , Mudança Climática , Ecossistema , Grécia , Florestas , Monitoramento Ambiental , Conservação dos Recursos Naturais
5.
J Periodontol ; 2024 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-39003566

RESUMO

BACKGROUND: This study compared titanium and zirconia implant ligature-induced peri-implant defect progression and response to regenerative surgical intervention. METHODS: Eight tissue-level endosseous implants were placed in 6 mixed-breed foxhounds, with 2 zirconia and 2 titanium alternating in each hemimandible. Cotton ligatures were placed subgingivally for 16 weeks followed by 8 weeks of spontaneous progression. Standardized radiographs were captured every 2 weeks to evaluate the rate of bone loss. Regenerative surgery was performed utilizing water-jet decontamination, enamel matrix derivative, and locally harvested autogenous bone. After 16 weeks of healing, final radiographic bone levels as well as probing depths, recession, and clinical attachment levels were assessed. RESULTS: All 48 implants integrated successfully. The final average post-ligature radiographic defects were 2.88 and 3.05 mm for titanium and zirconia implants, respectively. There was no significant difference between materials in the rate of radiographic bone loss (p = 0.09). Following regenerative surgery, the total average amount of radiographic bone gain was 1.41 and 1.20 mm for titanium and zirconia, respectively. The percentage of defect fill was 51.56% and 37.98% (p = 0.03) for titanium and zirconia, respectively. Inter-group differences were minimal for clinical parameters at the time of sacrifice including periodontal pocket depths (p = 0.81), recession (p = 0.98), or clinical attachment levels (p = 0.51). CONCLUSIONS: No significant difference was found in the rate of peri-implant defect development between titanium and zirconia implants. Both materials gained significant radiographic bone following regenerative surgery with significantly greater defect percentage fill in titanium implants. The final clinical parameters were similar in both groups.

6.
Cancers (Basel) ; 16(13)2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-39001455

RESUMO

T-cell-mediated anti-tumoral responses may have significant clinical relevance as a biomarker for response to immunotherapy. The value of peripheral blood pre-existing tumor antigen-specific T cells (PreI+) as a predictive immunotherapy biomarker in NSCLC patients was investigated, along with the frequency of various circulating immune cells. Fifty-two treatment-naïve, stage III/IV NSCLC patients, treated with front-line immune checkpoint inhibitors (ICI)-containing regimens were enrolled. PreI was calculated as the percentages of CD3+IFNγ+ cells after in vitro co-cultures of PBMCs with peptides against four different Tumor-Associated Antigens (TAA). Immunophenotyping of peripheral blood immune cells was performed using multicolor flow cytometry. PreI+ T cells were detected in 44% of patients. Median overall survival (OS) was significantly higher in PreI+ patients compared to PreI- patients (not reached vs. 321 days, respectively; p = 0.014). PreI+ patients had significantly higher numbers of possible exhausted CD3+CD8+PD-1+ cells and lower percentages of immunosuppressive Tregs compared to PreI- patients. Additionally, patients with PreI+ and low numbers of peripheral blood M-MDSCs had a significant survival advantage compared to the rest of the patients. Thus, combining pre-existing tumor antigen-specific immunity before initiation of ICI in NSCLC patients with selected immune-suppressive cells could identify patients who have a favorable clinical outcome when treated with ICI-containing regimens.

7.
PLoS One ; 19(6): e0305975, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38917148

RESUMO

OBJECTIVES: Periodontitis is a highly prevalent complication of diabetes. However, the association between cystic fibrosis-related diabetes (CFRD) and periodontitis has not yet been evaluated. The objective of this study was to assess if: 1) CFRD is associated with periodontitis among adults with CF, and 2) periodontitis prevalence differs by CF and diabetes status. METHODS: This was a pilot cross-sectional study of the association between CFRD and periodontitis in adults with cystic fibrosis (CF) (N = 32). Historical non-CF controls (N = 57) from the U.S. National Health and Nutrition Examination Survey (NHANES) dataset were frequency matched to participants with CF on age, sex, diabetes status, and insulin use. We defined periodontitis using the U.S. Centers for Disease Control and Prevention and the American Academy of Periodontology (CDC/AAP) case definition, as the presence of two or more interproximal sites with CAL ≥3 mm and two or more interproximal sites with PD ≥4 mm (not on the same tooth) or one site with PD ≥5 mm. Because NHANES periodontal data were only available for adults ages ≥30 years, our analysis that included non-CF controls focused on this age group (CF N = 19, non-CF N = 57). Based on CF and diabetes status, we formed four groups: CFRD, CF and no diabetes, non-CF with diabetes, and non-CF and no diabetes (healthy). We used the Fisher's exact test for hypotheses testing. RESULTS: There was no association between CFRD and periodontitis for participants with CF ages 22-63 years (CFRD 67% vs. CF no diabetes 53%, P = 0.49), this was also true for those ages ≥30 years (CFRD 78% vs. CF no diabetes 60%, P = 0.63). For the two CF groups, the prevalence of periodontitis was significantly higher than for healthy controls (CFRD 78% vs. healthy 7%, P<0.001; CF no diabetes 60% vs. healthy 7%, P = 0.001) and not significantly different than the prevalence for non-CF controls with diabetes (CFRD 78% vs. non-CF with diabetes 56%, P = 0.43; CF no diabetes 60% vs. non-CF with diabetes 56%, P = 0.99). CONCLUSION: Among participants with CF, CFRD was not associated with periodontitis. However, regardless of diabetes status, participants with CF had increased prevalence of periodontitis compared to healthy controls.


Assuntos
Fibrose Cística , Diabetes Mellitus , Periodontite , Humanos , Estudos Transversais , Periodontite/epidemiologia , Periodontite/complicações , Masculino , Adulto , Fibrose Cística/complicações , Fibrose Cística/epidemiologia , Feminino , Projetos Piloto , Diabetes Mellitus/epidemiologia , Prevalência , Pessoa de Meia-Idade , Complicações do Diabetes/epidemiologia , Adulto Jovem
9.
J Periodontol ; 95(7): 632-639, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38884613

RESUMO

BACKGROUND: The primary purpose of this two-arm, parallel design, randomized controlled study is to compare healing of the palatal tissue donor site when platelet-rich fibrin (PRF) is used as a wound dressing compared to the use of a hemostatic agent. Secondary outcomes of patient pain perception and analgesic intake were also evaluated. METHODS: Seventy-four patients receiving free gingival grafts were randomized to receive either PRF (test) or hemostatic agent (control) as a palatal wound dressing by patients selecting a sealed envelope containing their group assignment (initially 37 envelopes for PRF group and 37 for hemostatic agent group). Patient pain assessment and analgesic consumption were documented using a 21-point numerical scale (NMRS-21) at 24, 48, and 72 hours post-surgery. At 1-, 2-, 3-, and 4-week follow-up appointments palatal early healing index (PEHI) scores including wound color, epithelialization, presence or absence of swelling, granulation tissue, and bleeding on gentle palpation were generated by direct intraoral examination by a blinded examiner unaware of the patients' treatment group. RESULTS: NMRS-21 pain scores showed a significant reduction in pain over time in both groups, with no significant difference between groups at any time point. No significant between-group difference was found in the amount of analgesics taken by patients at 24, 48, and 72 hours. There was significant improvement in PEHI scores over the 4-week time period in both groups, but there was no significant difference in PEHI score at each time point (1, 2, 3, 4 weeks) between groups.  CONCLUSIONS: Study findings suggest that there is no difference in early palatal wound healing, patient pain perception, or analgesic consumption between use of PRF or a hemostatic agent as donor-site wound dressings.


Assuntos
Gengiva , Hemostáticos , Medição da Dor , Dor Pós-Operatória , Fibrina Rica em Plaquetas , Sítio Doador de Transplante , Cicatrização , Humanos , Feminino , Masculino , Cicatrização/efeitos dos fármacos , Adulto , Pessoa de Meia-Idade , Sítio Doador de Transplante/cirurgia , Hemostáticos/uso terapêutico , Seguimentos , Reepitelização , Analgésicos/uso terapêutico , Palato/cirurgia , Percepção da Dor , Adulto Jovem , Resultado do Tratamento , Tecido de Granulação
10.
J Periodontol ; 2024 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-38881046

RESUMO

BACKGROUND: Implant surface decontamination is a critical step in peri-implantitis treatment. The aim of this study was to assess the effect chemotherapeutic agents have on reosseointegration after treatment on ligature-inducted peri-implantitis. METHODS: Six male canines had 36 implants placed and ligatures were placed around them for 28 weeks to establish peri-implantitis. The peri-implant defects were randomly treated by 1 of 3 methods: 0.12% chlorhexidine (CHX test group), 1.5% sodium hypochlorite (NaOCl test group), or saline (Control group). Sites treated with NaOCl and CHX were grafted with autogenous bone, and all sites then either received a collagen membrane or not. Histology sections were obtained at 6 months postsurgery to assess percentage of reosseointegration. RESULTS: Thirty-five implants were analyzed (CHX: 13; NaOCl: 14; Control:8). NaOCl-treated sites demonstrated reosseointegration with direct bone-to-implant-contact on the previously contaminated surfaces (42% mean reosseointegration), which was significantly higher than Controls (p < 0.05). Correspondingly, clinical improvement was noted with a significant reduction in probing depth from 5.50 ± 1.24 mm at baseline to 4.46 ± 1.70 mm at 6-months postsurgery (p = 0.006). CHX-treated sites demonstrated a nonsignificant reosseointegration of 26% (p > 0.05); however, in the majority of cases, the new bone growth was at a distance from the implant surface without contact. Probing depths did not improve in the CHX group. The use of membrane did not influence reosseointegration or probing depths (all p > 0.05). CONCLUSION: Titanium implants with peri-implantitis have the capacity to reosseointegrate following regenerative surgery. However, treatment response is contingent upon the chemotherapeutic agent selection. Additional chemical treatment with 1.5% NaOCl lead to the most favorable results in terms of changes in defect depth and percentage of reosseointegration as compared to CHX, which may hinder reosseointegration.

11.
Nat Commun ; 15(1): 4263, 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38769301

RESUMO

Abrupt radiocarbon (14C) excursions, or Miyake events, in sequences of radiocarbon measurements from calendar-dated tree-rings provide opportunities to assign absolute calendar dates to undated wood samples from contexts across history and prehistory. Here, we report a tree-ring and 14C-dating study of the Neolithic site of Dispilio, Northern Greece, a waterlogged archaeological site on Lake Kastoria. Findings secure an absolute, calendar-dated time using the 5259 BC Miyake event, with the final ring of the 303-year-long juniper tree-ring chronology dating to 5140 BC. While other sites have been absolutely dated to a calendar year through 14C-signature Miyake events, Dispilio is the first European Neolithic site of these and it provides a fixed, calendar-year anchor point for regional chronologies of the Neolithic.

12.
Cells ; 13(9)2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38727318

RESUMO

CXCR4, JUNB and PD-L1 are implicated in cancer progression and metastasis. The current study investigated these biomarkers in CTCs isolated from metastatic prostate cancer (mPCa) patients at the RNA and protein levels. CTCs were isolated from 48 mPCa patients using the Ficoll density gradient and ISET system (17 out of 48). The (CK/PD-L1/CD45) and (CK/CXCR4/JUNB) phenotypes were identified using two triple immunofluorescence stainings followed by VyCAP platform analysis. Molecular analysis was conducted with an EpCAM-dependent method for 25/48 patients. CK-8, CK-18, CK-19, JUNB, CXCR4, PD-L1, and B2M (reference gene) were analyzed with RT-qPCR. The (CK+/PD-L1+/CD45-) and the (CK+/CXCR4+/JUNB+) were the most frequent phenotypes (61.1% and 62.5%, respectively). Furthermore, the (CK+/CXCR4+/JUNB-) phenotype was correlated with poorer progression-free survival [(PFS), HR: 2.5, p = 0.049], while the (CK+/PD-L1+/CD45-) phenotype was linked to decreased overall survival [(OS), HR: 262.7, p = 0.007]. Molecular analysis revealed that 76.0% of the samples were positive for CK-8,18, and 19, while 28.0% were positive for JUNB, 44.0% for CXCR4, and 48.0% for PD-L1. Conclusively, CXCR4, JUNB, and PD-L1 were highly expressed in CTCs from mPCa patients. The CXCR4 protein expression was associated with poorer PFS, while PD-L1 was correlated with decreased OS, providing new biomarkers with potential clinical relevance.


Assuntos
Antígeno B7-H1 , Células Neoplásicas Circulantes , Neoplasias da Próstata , Receptores CXCR4 , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Antígeno B7-H1/metabolismo , Antígeno B7-H1/genética , Biomarcadores Tumorais/metabolismo , Biomarcadores Tumorais/genética , Regulação Neoplásica da Expressão Gênica , Células Neoplásicas Circulantes/metabolismo , Células Neoplásicas Circulantes/patologia , Neoplasias da Próstata/patologia , Neoplasias da Próstata/genética , Neoplasias da Próstata/metabolismo , Proteínas Proto-Oncogênicas c-jun/metabolismo , Receptores CXCR4/metabolismo , Receptores CXCR4/genética
13.
Diabetes Res Clin Pract ; 211: 111664, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38604446

RESUMO

AIMS: The impact of newly detected diabetes mellitus (NDDM) on metabolic parameters and extent of myocardial necrosis in patients with acute coronary syndrome (ACS) is not fully explored. We examined the impact of NDDM on cardiometabolic characteristics and myocardial necrosis in ACS patients. METHODS: CALLINICUS-Hellas Registry is an ongoing prospective multicenter observational study evaluating the adherence to lipid-lowering therapy (LLT) among ACS patients in Greece. Three groups were created: a) patients with NDDM (abnormal fasting glucose, HbA1c ≥ 6.5 % and no previous history of DM), b) patients without known DM and HbA1c < 6.5 % (non-DM) and c) patients with prior DM. RESULTS: The prevalence of NDDM among 1084 patients was 6.9 %. NDDM patients had lower HDL-C [38 (32-45) vs 42 (36-50) mg/dL] and higher triglycerides levels [144 (104-231) vs 115 (87-152) mg/dL] compared to non-DM patients (p < 0.05). NDDM patients featured both higher body mass index [29.5 (26.4-34.3) vs 27.1 (24.9-29.9) kg/m2] and waist circumference [107 (100-114) vs 98 (91-106) cm] compared to non-DM patients (p < 0.05). In addition, NDDM patients had more extensive myocardial necrosis than patients with prior DM. CONCLUSIONS: ACS patients with NDDM have an adverse cardiometabolic profile similar to patients with prior DM and have more extensive myocardial insult.


Assuntos
Síndrome Coronariana Aguda , Humanos , Síndrome Coronariana Aguda/sangue , Síndrome Coronariana Aguda/complicações , Síndrome Coronariana Aguda/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Estudos Prospectivos , Diabetes Mellitus/epidemiologia , Hemoglobinas Glicadas/metabolismo , Hemoglobinas Glicadas/análise , Glicemia/metabolismo , Glicemia/análise , Grécia/epidemiologia , Isquemia Miocárdica/epidemiologia , Isquemia Miocárdica/sangue , Sistema de Registros , Prevalência
14.
Sports (Basel) ; 12(4)2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38668569

RESUMO

This cross-sectional epidemiological study aimed to evaluate the prevalence of injuries among young archers engaged in high-intensity training during the European Youth Championship. A total of 200 participants (104 males/96 females) from 34 countries were included, with a mean age of 16.9 years and average competitive experience of 6.5 years. Structured questionnaires, administered by four physiotherapist interviewers, gathered comprehensive data. Results revealed that 43.5% of participants experienced shoulder pain during training, highlighting the vulnerability of upper limbs in archers. Additionally, 30% required medications to facilitate training, underscoring the impact of injuries on continued participation. Physiotherapy was utilized by 52.3% of participants, emphasizing the need for therapeutic intervention. Furthermore, 31.8% had to cease training due to injuries, indicating a substantial hindrance to athletic progression. The mean pain duration was 3.9 months, with an average intensity of 5.94, and 8% exhibited symptoms of central sensitization. In conclusion, this study demonstrates a noteworthy prevalence of injuries, particularly in the upper limbs, among young archers undergoing intensive training. The findings underscore the importance of targeted injury prevention strategies and comprehensive rehabilitation approaches to ensure the well-being and sustained participation of young athletes in competitive archery.

15.
JDR Clin Trans Res ; 9(4): 378-386, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38482579

RESUMO

KNOWLEDGE TRANSFER STATEMENT: Our proposed estimate of periodontitis susceptibility cases addresses the issue of missing teeth, offering an innovative solution through a generative missing data imputation model. The implications of our findings extend to fostering more robust investigations into the relationships between periodontal health and systemic diseases, thereby offering valuable insights to clinicians for informed decision-making. Moreover, the study's capacity to shape clinical practices and interventions in public health will further fortify health policy strategies.


Assuntos
Periodontite , Humanos , Periodontite/epidemiologia , Suscetibilidade a Doenças , Estudos Epidemiológicos
16.
Biomedicines ; 12(1)2024 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-38255251

RESUMO

SCLC is an aggressive cancer type with high metastatic potential and bad prognosis. CTCs are a valuable source of tumor cells in blood circulation and are among the major contributors to metastasis. In this study we evaluated the number of CTCs that express PD-L1 in treatment-naïve ES-SCLC patients receiving ICI in a front-line setting. Moreover, we explored the percentages of different immune T-cell subsets in circulation to assess their potential role in predicting responses. A total of 43 patients were enrolled-6 of them with LS-SCLC, and 37 with ES-SCLC disease. In addition, PBMCs from 10 healthy donors were used as a control group. Different T-cell subtypes were examined through multicolor FACS analysis and patients' CTCs were detected using immunofluorescence staining. SCLC patients had higher percentages of PD-1-expressing CD3+CD4+ and CD3+CD8+ T-cells, as well as elevated PD-1 protein expression compared to healthy individuals. Additionally, in ES-SCLC patients, a positive correlation between CD3+CD8+PD-1+ T-cells and PD-L1+ CTCs was detected. Importantly, patients harboring higher numbers of CD3+CD8+PD-1+ T-cells together with PD-L1+CTCs had a survival advantage when receiving front-line immunotherapy. Thus, this study proposes, for first time possible, immune cell-CTCs interaction, as well as a potential novel clinical biomarker for ICI responses in ES-SCLC patients.

17.
J Dent Res ; 103(3): 235-242, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-37910667

RESUMO

Odontogenic pain can be debilitating, and nonopioid analgesic options are limited. This randomized placebo-controlled clinical trial aimed to assess the effectiveness and safety of cannabidiol (CBD) as an analgesic for patients with emergency acute dental pain. Sixty-one patients with moderate to severe toothache were randomized into 3 groups: CBD10 (CBD 10 mg/kg), CBD20 (CBD 20 mg/kg), and placebo. We administered a single dose of respective oral solution and monitored the subjects for 3 h. The primary outcome measure was the numerical pain differences using a visual analog scale (VAS) from baseline within and among the groups. Secondary outcome measures included ordinal pain intensity differences, the onset of significant pain relief, maximum pain relief, changes in bite force within and among the groups, psychoactive effects, mood changes, and other adverse events. Both CBD groups resulted in significant VAS pain reduction compared to their baseline and the placebo group, with a maximum median VAS pain reduction of 73% from baseline pain at the 180-min time point (P < 0.05). CBD20 experienced a faster onset of significant pain relief than CBD10 (15 versus 30 min after drug administration), and both groups reached maximum pain relief at 180-min. Number needed to treat was 3.1 for CBD10 and 2.4 for CBD20. Intragroup comparisons showed a significant increase in bite forces in both CBD groups (P < 0.05) but not in the placebo group (P > 0.05). CBD20 resulted in a significant difference in mean percent bite force change in the 90- and 180-min time points compared to the placebo group (P < 0.05). Compared to placebo, sedation, diarrhea, and abdominal pain were significantly associated with the CBD groups (P < 0.05). There were no other significant psychoactive or mood change effects. This randomized trial provides the first clinical evidence that oral CBD can be an effective and safe analgesic for dental pain.


Assuntos
Dor Aguda , Analgésicos não Narcóticos , Canabidiol , Humanos , Canabidiol/efeitos adversos , Analgésicos não Narcóticos/efeitos adversos , Dor , Método Duplo-Cego , Dor Pós-Operatória/tratamento farmacológico , Dor Aguda/tratamento farmacológico , Dor Aguda/induzido quimicamente
18.
J Cardiol ; 83(5): 313-317, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-37979719

RESUMO

BACKGROUND: Current guidelines recommend a rhythm control strategy in patients with symptomatic atrial fibrillation (AF) while catheter ablation has been shown to be a safer and more efficacious approach than antiarrhythmic medications. METHODS: HECMOS was a nationwide snapshot survey of cardiorenal morbidity in hospitalized cardiology patients. In this sub-study, we included 276 cases who had a history of AF, particularly on the rhythm strategy, and catheter ablation procedures had been performed before the index admission. RESULTS: Among 276 AF patients (mean age: 76.4 ±â€¯11.5 years, 58 % male), 60.9 % (N = 168) had persistent AF and 39.1 % (N = 108) had paroxysmal AF. Heart failure was the main cause of admission in 54.3 % (N = 145) of the patients, while 14.1 % (N = 39) were admitted due to paroxysmal AF, 7.3 % (N = 20) due to bradyarrhythmic reasons, and 6.5 % (N = 18) suffered from acute coronary syndrome. Most importantly, heart failure with reduced ejection fraction was present in 76 (27 %) patients. Only 10 patients out of the total (3 %, mean age 59.7 years) had undergone AF ablation while electrical cardioversion had been attempted in 37 (13.4 %) patients. Interestingly, in this AF population with heart failure, 3.6 % (N = 10) had a defibrillator implanted (4 single-chamber), and only 1.5 % (N = 4) had a cardiac resynchronization therapy defibrillator (CRT-D). CONCLUSION: High prevalence of persistent AF was detected in hospitalized patients, with heart failure being the leading cause of admission and main co-morbidity. Rhythm control strategies are notably underused, along with CRT-D implantation in patients with AF and heart failure.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Insuficiência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Feminino , Fibrilação Atrial/terapia , Fibrilação Atrial/tratamento farmacológico , Antiarrítmicos/uso terapêutico , Cardioversão Elétrica , Prevalência , Ablação por Cateter/efeitos adversos , Resultado do Tratamento
19.
J Clin Periodontol ; 51(3): 309-318, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-38088457

RESUMO

AIM: To evaluate the effect of different oral irrigators on the sub-gingival microbiome composition in patients with naturally occurring plaque-induced gingivitis. MATERIALS AND METHODS: Sub-gingival plaque was collected from adults participating in a clinical trial assessing the efficacy of oral hygiene with two different oral irrigators (Waterpik Water Flosser [Group 1] and Oral-B Water Flosser [Group 2]) versus dental flossing (Group 3) for microbiome analysis. Plaque samples were reflective of naturally occurring plaque-induced gingivitis at baseline and of gingival health at the endpoint (4 weeks). Clinical measures of gingival inflammation were collected, and the sub-gingival microbiome was analysed by 16S rRNA sequencing to identify amplicon sequence variants. RESULTS: Oral hygiene instruction with self-performed manual toothbrushing and water-jet irrigation led to significant reductions in inflammation for all groups; both oral irrigators outperformed flossing in bleeding-on-probing reduction (p < .001). Microbiome diversity of sub-gingival plaque remained relatively stable over time, but significant changes were noted in certain taxa, consistent with increases in the relative abundance of commensals and reductions in late colonizers and periodontal pathogens in the water-jet groups. CONCLUSIONS: Reduction in gingival inflammation at 4 weeks within the water-jet groups is accompanied by slight but critical changes in microbiome composition. Although biodiversity does not substantially change within 4 weeks during the resolution of naturally induced gingivitis, significant relative increases in commensal early colonizers such as Streptococcus, Veillonella and Fusobacterium were accompanied by a shift towards a less anaerobic microbiota associated with return to health. These changes were contingent upon the type of interdental hygiene, with Group 1 exhibiting more significant alterations in microbiome composition towards a periodontal-health-compatible community.


Assuntos
Placa Dentária , Gengivite , Adulto , Humanos , Higiene Bucal , Dispositivos para o Cuidado Bucal Domiciliar , Análise de Dados Secundários , RNA Ribossômico 16S , Índice de Placa Dentária , Escovação Dentária , Gengivite/prevenção & controle , Placa Dentária/prevenção & controle , Inflamação , Água , Método Simples-Cego
20.
J Pharmacol Exp Ther ; 388(2): 526-535, 2024 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-37977813

RESUMO

Sulfur mustard (SM) is a highly reactive organic chemical has been used as a chemical warfare agent and terrorist threat since World War I. The cornea is highly sensitive to SM toxicity and exposure to low vapor doses can cause incapacitating acute injuries. Exposure to higher doses can elicit persistent secondary keratopathies that cause reduced quality of life and impaired or lost vision. Despite a century of research, there are no specific treatments for acute or persistent ocular SM injuries. SM cytotoxicity emerges, in part, through DNA alkylation and double-strand breaks (DSBs). Because DSBs can naturally be repaired by DNA damage response pathways with low efficiency, we hypothesized that enhancing the homologous recombination pathway could pose a novel approach to mitigate SM injury. Here, we demonstrate that a dilithium salt of adenosine diphosphoribose (INV-102) increases protein levels of p53 and Sirtuin 6, upregulates transcription of BRCA1/2, enhances γH2AX focus formation, and promotes assembly of repair complexes at DSBs. Based on in vitro evidence showing INV-102 enhancement of DNA damage response through both p53-dependent and p53-independent pathways, we next tested INV-102 in a rabbit preclinical model of corneal injury. In vivo studies demonstrate a marked reduction in the incidence and severity of secondary keratopathies in INV-102-treated eyes compared with vehicle-treated eyes when treatment was started 24 hours after SM vapor exposure. These results suggest DNA repair mechanisms are a viable therapeutic target for SM injury and suggest topical treatment with INV-102 is a promising approach for SM as well as other conditions associated with DSBs. SIGNIFICANCE STATEMENT: Sulfur mustard gas corneal injury currently has no therapeutic treatment. This study aims to show the therapeutic potential of activating the body's natural DNA damage response to activate tissue repair.


Assuntos
Substâncias para a Guerra Química , Lesões da Córnea , Gás de Mostarda , Animais , Coelhos , Gás de Mostarda/toxicidade , Proteína BRCA1 , Proteína Supressora de Tumor p53 , Qualidade de Vida , Proteína BRCA2 , Lesões da Córnea/induzido quimicamente , Lesões da Córnea/tratamento farmacológico , Substâncias para a Guerra Química/toxicidade , Reparo do DNA , Dano ao DNA
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