The Significance of Keratinized Mucosa in Implant Therapy: Narrative Literature Review and Case Report Presentation.

Background/Objectives: Implant treatment in patients who require teeth extraction due to periodontitis presents a significant challenge. The consideration of peri-implantitis is crucial when planning the placement of dental implants. The predictability of implant treatment relies on the suitability of both hard and soft tissue quality. The aim of this article is to present a case report demonstrating a secure treatment protocol for implant procedures in patients with periodontitis requiring the extraction of all teeth, soft tissue management targeted at increasing the keratinized mucosa zone, and the provision of a reliable prosthetic solution. The secondary objective is to review the relevant literature regarding the significance of keratinized mucosa surrounding dental implants and its association with the occurrence of peri-implantitis. Case presentation: A 65-year-old female with generalized periodontitis, stage IV grade C and very poor oral hygiene came for treatment and rehabilitation of the lower jaw. CBCT revealed periodontal lesions and labio-lingual ridge dimensions in the region of teeth 34-44 from 8.0 to 10.2 mm. The first surgery included teeth extraction and periodontal lesions enucleation with simultaneous placement of four implants in the positions of teeth 32, 34, 42, 44. The second-stage surgery involved increasing the keratinized mucosa using two free gingival grafts. Conclusions: The present case report described the treatment process of the patient with periodontitis, including immediate implantation in the infected region, soft tissue augmentation using free gingival grafts and the ultimate placement of a bar-retained overdenture for final restoration. After two years of observation, despite questionable hygiene, no symptoms of gingival inflammation were detected. Furthermore, there is limited information in the literature regarding the correlation between inadequate keratinized gingiva and the occurrence of peri-implantitis.

[Risk assessment and toxicity effects of materials used during additive manufacturing with FDM technology]. / Ocena zagrozen i dzialanie toksyczne materialów stosowanych podczas drukowania przestrzennego w technologii FDM.

This paper discusses the potential of additive printing, the risks it poses to users' health (including 3D printer operators) and the effects of chemical substances released during the printing based on the available in vitro and in vivo studies. It was shown that substances emitted during printing with the commonly used acrylonitrile butadiene styrene filament in additive manufacturing might have carcinogenic, hepatotoxic and teratogenic effects, as well as toxic effect on the respiratory system. The latest research on the mechanism of formation of particles and volatile organic compounds during 3D printing, the parameters affecting their potential emission, and trends in reducing these hazards are indicated. The need for the design of more environmentally friendly and less emissive printing materials, as well as strategies for prevention and individual and collective protection measures are emphasized. Users of 3D printers should be familiar with all possible aspects of the threats associated with the printing process. Insufficient data on direct exposure to chemicals and particles released during the use of filaments makes it difficult to build awareness of safe working practices. Of particular concern is the health impact of emitted chemicals and particles from thermally treated materials in one of the most popular technologies for 3D printing, i.e., fused deposition modelling. Exposure of the users to, e.g., plasticizers added to filaments occurs through a variety of routes, by absorption through the skin, by inhalation or ingestion. Available epidemiological data, as well as current experimental works, indicate that such exposure is a high risk of cardiovascular diseases, atherosclerosis in adults, and cardiac problems and metabolic disorders in children. This review, by identifying potential risk factors, may contribute to reducing the health loss of printer users and improving working conditions and safety, especially in enterprises where additive manufacturing technology is used. Med Pr Work Health Saf. 2024;75(2):159-171.

Pembrolizumab-combination therapy for NSCLC- effectiveness and predictive factors in real-world practice.

Introduction: Pembrolizumab combined with chemotherapy has become the standard of care for patients with non-small-cell lung cancer (NSCLC) and the expression of programmed death ligand 1 (PD-L1) in <50% of tumour cells (TC). Methods: We evaluated the efficacy of the treatment in real-world practice, paying attention to the predictive factors, with a special focus on low level of PD-L1 expression. This study is a multicenter retrospective analysis of patients with stage IV NSCLC. Results: A group of 339 consecutive patients was analysed, among them 51% patients with low PD-L1 expression. In the overall population, the ORR was 40.6%, median PFS and OS were 13 months (95% CI 11.4-15) and 16.8 months (95% CI 13.3-20.3), respectively. In multivariate analysis for the entire study population, performance status - ECOG 1 vs. 0 (HR 2.2, 95%CI 1.1-4.6; p=0.02), neutrophil to lymphocyte ratio (NLR)>3 (HR 2.3, 95%CI 1.3-4.2; p=0.04), presence of liver (HR 2.0, 95%CI 1-3.7; p=0. 03) and bone metastases (HR 1.3, 95%CI 1-3; p=0.04), weight loss (HR 1.8, 95%CI 1.1-2.8; p=0.01) and sum of measurable lesions diameters >110 mm (HR 1.7, 95%CI 1-2.9, p=0.049) had a negative impact on OS. Conclusions: In the real world, patients can clinically benefit from immunochemotherapy, regardless of the expression of PD-L1 and the histological type. Other clinicopathological factors such as performance status, extent, and location of secondary lesions have prognostic significance.

Clinical effectiveness and safety of olaparib in BRCA-mutated, HER2-negative metastatic breast cancer in a real-world setting: final analysis of LUCY.

PURPOSE: The interim analysis of the phase IIIb LUCY trial demonstrated the clinical effectiveness of olaparib in patients with germline BRCA-mutated (gBRCAm), human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (mBC), with median progression-free survival (PFS) of 8.11 months, which was similar to that in the olaparib arm of the phase III OlympiAD trial (7.03 months). This prespecified analysis provides final overall survival (OS) and safety data. METHODS: The open-label, single-arm LUCY trial of olaparib (300 mg, twice daily) enrolled adults with gBRCAm or somatic BRCA-mutated (sBRCAm), HER2-negative mBC. Patients had previously received a taxane or anthracycline for neoadjuvant/adjuvant or metastatic disease and up to two lines of chemotherapy for mBC. RESULTS: Of 563 patients screened, 256 (gBRCAm, n = 253; sBRCAm, n = 3) were enrolled. In the gBRCAm cohort, median investigator-assessed PFS (primary endpoint) was 8.18 months and median OS was 24.94 months. Olaparib was clinically effective in all prespecified subgroups: hormone receptor status, previous chemotherapy for mBC, previous platinum-based chemotherapy (including by line of therapy), and previous cyclin-dependent kinase 4/6 inhibitor use. The most frequent treatment-emergent adverse events (TEAEs) were nausea (55.3%) and anemia (39.2%). Few patients (6.3%) discontinued olaparib owing to a TEAE. No deaths associated with AEs occurred during the study treatment or 30-day follow-up. CONCLUSION: The LUCY patient population reflects a real-world population in line with the licensed indication of olaparib in mBC. These findings support the clinical effectiveness and safety of olaparib in patients with gBRCAm, HER2-negative mBC. CLINICAL TRIAL REGISTRATION: Clinical trials registration number: NCT03286842.

Pressure Drop Dynamics during Filtration of Mixture Aerosol Containing Water, Oil, and Soot Particles on Nonwoven Filters.

The pressure drop dynamics during the filtration of three-component mixture aerosols are investigated and compared with two and single-component aerosols. The main area of interest is the effect of the addition of a small quantity of liquid (oil) and solid (soot) particles during the filtration of aerosol containing water mist. In addition, calculations of the change in filter mass during oil aerosol filtration have been carried out and compared with the experimental results. The new, improved filtration efficiency model takes into account a better coefficient fitting in the filtration mechanism equations. The limitations in the change in fibre diameter and packing density resulting from the filter loading have been implemented in the model. Additionally, the calculation model employs the fibre size distribution representation via multiple average fibre diameters. The changes in fibre diameter are dependent on each fibre's calculated filtration efficiency. The improved filtration model has been utilised to predict the mass change of the filters during the filtration of pure and mixture aerosols. The pressure drop calculation model based on changes in filter mass has been formulated. The model is then utilised to calculate pressure drop changes resulting from the filtration of the oil aerosol and water and oil mixture aerosol.

Improved Detection of Endoleaks in Virtual Monoenergetic Images in Dual-Energy CT Angiography Following EVAR.

OBJECTIVES: The objective of this prospective study was to evaluate the virtual monoenergetic images (VMI) and virtual noncontrast (VNC) phase in the detection of endoleaks after endovascular abdominal aortic repair (EVAR). The potential dose reduction of abbreviated examination protocols was calculated. MATERIALS AND METHODS: Ninety-seven patients after the EVAR procedure were enrolled in this study. An initial single-source noncontrast acquisition was followed by two dual-energy acquisitions (arterial and 60 s delayed). Fast-kVp switching scanner was used. VNC images were reconstructed from the delayed phase. First examination session (reference) included a full triphasic study protocol consisting of true noncontrast (TNC) images and two postcontrast phases, the latter ones presented as classical polyenergetic reconstructions. Reading sessions II and III were performed by two independent and blinded readers evaluating VMIs in abbreviated protocols-biphasic (VNC + arterial, delayed phase), monophasic (VNC + delayed phase). The diagnostic accuracy of sessions II and III was calculated. RESULTS: The calculated sensitivity of the biphasic protocol with the use of VMIs in endoleak detection was 100%, with a statistically significant increase in the number of endoleaks detected in comparison with the reference study. The monophasic protocol showed 83.33% sensitivity. The use of abbreviated examination protocols led to a decrease in the mean effective dose (ED) of 23.28% (biphasic protocol) and 61.37% (monophasic protocol). CONCLUSION: The use of VMIs increases the number of endoleaks diagnosed with a possible radiation reduction by up to » (biphasic protocol). Further reduction to a monophasic protocol leads to over 60% dose reduction but with a decrease in diagnostic accuracy.

The Influence of Air Humidity on the Output Signal from an Ionization Smoke Detector in the Presence of Soot Nanoparticles.

In 2019, the European Committee for Standardization (CEN) initiated work on the preparation of a strategy for air quality monitoring at workplaces. The aim was to determine the concentrations of nano-objects and their aggregates and agglomerates (NOAA) by means of direct measurements using low-cost sensors. There is a growing need for low-cost devices that can continuously monitor the concentrations of nanoparticles, and that can be installed where nanoparticles are used or created spontaneously. In search of such a device, in this study, a smoke detector with an ionization sensor was tested. The aim of the research was to investigate the response of the analog output signal with respect to changes in environmental parameters such as the relative humidity of air. The research was conducted in controlled laboratory conditions, and the results confirmed that an ionization detector could be used to measure the concentrations of nanoaerosols. The modified smoke detector detected soot particles smaller than 100 nm. The linear regression line was calculated for the relative humidity dataset and had a slope coefficient of -1.214 × 10-4; thus, the value of the output signal was constant during the experiment. The dependence on air temperature was approximated by a second-degree curve, with a slope coefficient of -8.113 × 10-2. Air humidity affected aerosol concentrations, which may be related to surface modification of nanoparticles.

The efficacy of T790M mutation testing in liquid biopsy-Real clinic data.

Osimertnib is still widely used in the treatment of NSCLC patients who have previously received erlotinib, gefitinib or afatinib and have developed resistance to these drugs mediated by the T790M mutation in exon 20 of EGFR gene. We assessed the results of T790M mutation testing in liquid biopsy by Entrogen test and real-time PCR technique in routine clinical practice. Analysis was conducted in 73 plasma samples from 41 patients with locally advanced or metastatic lung adenocarcinoma treated with first- or second-generation of EGFR TKIs. We detected T790M mutation in 18 patients (43.9% of patients, 24.6% positive tests in 73 samples). The incidence of T790M mutation in liquid biopsy was significantly higher in patients with T3-T4 tumors compared to patients with T0-T2 tumors (p = 0.0368, χ2 = 4.36). Median PFS at the time of progression according to RECIST was significantly (p = 0.0444) higher in patients with T790M mutation than in patients without this mutation (22.5 vs. 15 months). Our results confirmed that T790M mutation is more often detected in patients with a large tumor spreading in the chest and with the long duration of response to first- or second generation of EGFR TKIs. The low sensitivity of the real-time PCR technique in T790M mutation detection could be partially compensated by repeating the tests.

Quantitative measurements of tumoral p95HER2 protein expression in metastatic breast cancer patients treated with trastuzumab: independent validation of the p95HER2 clinical cutoff.

PURPOSE: P95HER2 (p95) is a truncated form of the HER2, which lacks the trastuzumab-binding site and contains a hyperactive kinase domain. Previously, an optimal clinical cutoff of p95 expression for progression-free survival (PFS) and overall survival (OS) was defined using a quantitative VeraTag assay (Monogram Biosciences) in a training set of trastuzumab-treated metastatic breast cancer (MBC) patients. EXPERIMENTAL DESIGN: In the current study, the predictive value of the p95 VeraTag assay cutoff established in the training set was retrospectively validated for PFS and OS in an independent series of 240 trastuzumab-treated MBC patients from multiple institutions. RESULTS: In the subset of 190 tumors assessed as HER2-total (H2T)-positive using the quantitative HERmark assay (Monogram Biosciences), p95 VeraTag values above the predefined cutoff correlated with shorter PFS (HR = 1.43; P = 0.039) and shorter OS (HR = 1.94; P = 0.0055) where both outcomes were stratified by hormone receptor status and tumor grade. High p95 expression correlated with shorter PFS (HR = 2.41; P = 0.0003) and OS (HR = 2.57; P = 0.0025) in the hormone receptor-positive subgroup of patients (N = 78), but not in the hormone receptor-negative group. In contrast with the quantitative p95 VeraTag measurements, p95 immunohistochemical expression using the same antibody was not significantly correlated with outcomes. CONCLUSIONS: The consistency in the p95 VeraTag cutoff across different cohorts of patients with MBC treated with trastuzumab justifies additional studies using blinded analyses in larger series of patients.

Correlation between quantitative HER-2 protein expression and risk for brain metastases in HER-2+ advanced breast cancer patients receiving trastuzumab-containing therapy.

BACKGROUND: Patients with human epidermal growth factor receptor (HER)-2+ breast cancer are at particularly high risk for brain metastases; however, the biological basis is not fully understood. Using a novel HER-2 assay, we investigated the correlation between quantitative HER-2 expression in primary breast cancers and the time to brain metastasis (TTBM) in HER-2+ advanced breast cancer patients treated with trastuzumab. METHODS: The study group included 142 consecutive patients who were administered trastuzumab-based therapy for HER-2+ metastatic breast cancer. HER-2/neu gene copy number was quantified as the HER-2/centromeric probe for chromosome 17 (CEP17) ratio by central laboratory fluorescence in situ hybridization (FISH). HER-2 protein was quantified as total HER-2 protein expression (H2T) by the HERmark® assay (Monogram Biosciences, Inc., South San Francisco, CA) in formalin-fixed, paraffin-embedded tumor samples. HER-2 variables were correlated with clinical features and TTBM was measured from the initiation of trastuzumab-containing therapy. RESULTS: A higher H2T level (continuous variable) was correlated with shorter TTBM, whereas HER-2 amplification by FISH and a continuous HER-2/CEP17 ratio were not predictive (p = .013, .28, and .25, respectively). In the subset of patients that was centrally determined by FISH to be HER-2+, an above-the-median H2T level was significantly associated with a shorter TTBM (hazard ratio, [HR], 2.4; p = .005), whereas this was not true for the median HER-2/CEP17 ratio by FISH (p = .4). Correlation between a continuous H2T level and TTBM was confirmed on multivariate analysis (HR, 3.3; p = .024). CONCLUSIONS: These data reveal a strong relationship between the quantitative HER-2 protein expression level and the risk for brain relapse in HER-2+ advanced breast cancer patients. Consequently, quantitative assessment of HER-2 protein expression may inform and facilitate refinements in therapeutic treatment strategies for selected subpopulations of patients in this group.

Effect of gamma-radiation and microwave heating of wheat grain on some starch properties in irradiated grain as well as in grain of the next generation crops.

Grains of the Polish winter wheat variety Begra were subjected to gamma-radiation (grain harvested in 1996) within the dose range of 0.05-10 kGy and microwave heating (grain harvested in 1997) from 28 degrees C to 98 degrees C. Later the grains were divided into two parts, the first was used for direct analyses after treatment. The second part was sown on the experimental fields. The obtained crop was described as the first generation and divided into two parts. One part was destined to determination of starch properties and the second part was sown in order to obtain the second generation crop. The same pattern was conducted in order to achieve the third generation crop. gamma-Irradiation directly applied on the wheat grain reduced statistically significant falling number values and gelatinisation enthalpy (deltaH) of the grain treated by 5 and 10 kGy. Calculated linear regression correlation coefficient between the falling number values and the gelatinisation enthalpy was equal to 0.94 (p < or = 0.001) and showed that these two starch characteristics are well correlated in the case of directly irradiated wheat grain. The falling number values, peak temperatures (Tp) and gelatinisation enthalpy (deltaH), in three generations of wheat grain crop studied, did not show any statistically significant differences as a result of indirect effect of gamma-irradiation. Microwave direct heating of wheat grain to 98 degrees C caused a statistically significant increase in the falling number value and decrease in starch gelatinisation power expressed by the enthalpy of gelatinisation (deltaH). The statistically significant changes in the falling number values, slight changes in the peak temperatures (Tp) and enthalpy of gelatinisation (deltaH) were found in all three generation crops as an indirect effect of microwave heating.