The impact of flaxseed oil on lipid profiles, weight loss, and inflammatory markers in hemodialysis patients: A systematic review and meta-analysis of randomized controlled trials.

Studies investigating the effects of flaxseed oil on lipid profiles, weight loss, and inflammatory markers have produced inconsistent results. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to explore the impact of flaxseed oil on these parameters in hemodialysis patients. The study protocol was registered online (PROSPERO number: CRD42023484076). The meta-analyses showed a significant decrease in triglyceride (TG) levels (WMD = -85.78 mg/dL, 95% CI: -155.24 to -16.32, I2 = 98.32%) and C-reactive protein (CRP) levels (WMD = -2.66 mg/L, 95% CI: -4.07 to -1.24, I2 = 92.26%) following consumption of flaxseed oil. Subgroup analyses revealed significant changes in LDL-C, HDL-C, and TC levels only in trials utilizing a dosage higher than 10 g per day and using ground flaxseed oil. Based on the results, flaxseed oil improves CRP and TG levels, and higher doses positively affect lipid profiles. However, it has no significant effect on anthropometric measures.

Does lifestyle modification (physical exercise and listening to music) improve symptoms in patients with a temporomandibular disorder? A randomized clinical trial.

Introduction: The aim of the study was to compare pain relief in temporomandibular disorder (TMD) patients with or without lifestyle modification. Materials and Methods: This randomized clinical trial was performed on patients with TMD, who did not regularly exercise or listen to music. The participants were allocated into two groups. In the treatment group, the participants were instructed to exercise five times or more per week (30 minutes per session) and listen to the music of their choice five times or more per week (15 minutes per session) for 12 weeks. In the control group, the participants had their usual lifestyle without any modifications. The participants were examined for clicking and crepitus in the joint and maximum mouth opening before and after the intervention. The pain severity was also documented based on a visual analog scale. Results: Thirty five patients were studied in each group. Twelve weeks after the intervention, the mean pain severity was 2.70 ± 0.73 in the treatment group and 4.63 ± 0.77 in the control group. The results of data analysis demonstrated a significant difference between the two groups regarding the mean pain severity at 12 weeks after the intervention (P <.001). Conclusions: Lifestyle modification through physical exercise and listening to music may reduce pain in TMD patients.

The Evaluation of Condylar Position Change in the Asymmetric Mandible Following Sagittal Split Osteotomy.

BACKGROUND: The change of condyle position following orthognathic surgery affects the stability of treatments. This study aims to assess the correlation between the amount of condyles' position change and the severity of mandibular asymmetry following BSSO. MATERIALS AND METHODS: This is a cross-sectional study. Subjects with asymmetric mandibular prognathism following BSSO were studied. Subjects were classified into 2 groups: group 1, subjects had mandibular asymmetry without occlusal cant and underwent BSSO. Group 2, subjects had mandibular asymmetry with occlusal cant and underwent BSSO+ Lefort I osteotomy. The condyle position was evaluated using cone-beam computer tomography (CBCT). Pearson's correlation test was used to assess any correlation between the condyle changes and the change in the mandible in sagittal and anterior-posterior directions. RESULTS: A total of 44 subjects were studied. In group 1, the condyle tilted outward in the deviated condyle and inward in the non-deviated condyle immediately after osteotomy. After 12 months, both condyles showed a rotation relative to the original position. In group 2, the condyles of the deviated sides and non-deviated sides moved inferiorly after surgery (condylar sagging), which was more significant in the non-deviated sides. The condyle rotation was similar to group 1. The severity of asymmetry and occlusal cant correlate with the condylar position change in the two groups. CONCLUSION: The severity of mandibular asymmetry correlates with the amount of condyles' position change immediately after BSSO. However, the condyles tend to return to their original position 12 months later.

Evaluation of AI-generated responses by different artificial intelligence chatbots to the clinical decision-making case-based questions in oral and maxillofacial surgery.

OBJECTIVES: This study aims to evaluate the correctness of the generated answers by Google Bard, GPT-3.5, GPT-4, Claude-Instant, and Bing chatbots to decision-making clinical questions in the oral and maxillofacial surgery (OMFS) area. STUDY DESIGN: A group of 3 board-certified oral and maxillofacial surgeons designed a questionnaire with 50 case-based questions in multiple-choice and open-ended formats. Answers of chatbots to multiple-choice questions were examined against the chosen option by 3 referees. The chatbots' answers to the open-ended questions were evaluated based on the modified global quality scale. A P-value under .05 was considered significant. RESULTS: Bard, GPT-3.5, GPT-4, Claude-Instant, and Bing answered 34%, 36%, 38%, 38%, and 26% of the questions correctly, respectively. In open-ended questions, GPT-4 scored the most answers evaluated as grades "4" or "5," and Bing scored the most answers evaluated as grades "1" or "2." There were no statistically significant differences between the 5 chatbots in responding to the open-ended (P = .275) and multiple-choice (P = .699) questions. CONCLUSION: Considering the major inaccuracies in the responses of chatbots, despite their relatively good performance in answering open-ended questions, this technology yet cannot be trusted as a consultant for clinicians in decision-making situations.

Association between dietary total antioxidant capacity and the risk of stroke: a nested case-control study.

BACKGROUND: Oxidative stress after ischemic stroke contribute to neuronal cell injury. Unhealthy and unbalanced dietary patterns can increase the risk of several diseases, including stroke and cardiometabolic ones. However, the association between dietary total antioxidant capacity (DTAC) of antioxidant and stroke is controversial. Our study aimed to establish a correlation between DTAC and its impact on the occurrence of stroke. METHODS: This nested case-control study included 79 stroke cases and 158 healthy controls. We used data from the Fasa Adults Cohort Study (FACS) comprising 10,035 individuals at baseline. To assess the nutritional status of each individual, a 125-item food frequency questionnaire (FFQ) has been used to evaluate their dietary habits and intakes over the past year. DTAC was calculated using the ferric-reducing antioxidant power (FRAP) international databases. The stroke was confirmed by an experienced neurologist using standard imaging methods. Conditional logistic regression analyses were performed to evaluate the association between DTAC and stroke. RESULTS: The assessment of DTAC revealed that there was no statistically significant distinction between cases (mean ± SD: 5.31 ± 2.65) and controls (5.16 ± 2.80) with a p-value of 0.95. Even after adjusting for the potentially important confounding factors such as age, sex, event time, energy intake, smoking, hypertension, and diabetes, the association remains non-significant (adjusted odds ratio (OR) = 1.06, 95% CI: 0.94, 1.20, p-value = 0.33). CONCLUSIONS: Our results did not confirm a significant link between DTAC and stroke risk. These findings emphasize the intricate interplay of factors influencing stroke risk and highlight the need for further research to unravel these relationships more comprehensively.

miR-939, as an important regulator in various cancers pathogenesis, has diagnostic, prognostic, and therapeutic values: a review.

BACKGROUND: MicroRNAs (miRNAs or miRs) are highly conserved non-coding RNAs with a short length (18-24 nucleotides) that directly bind to a complementary sequence within 3'-untranslated regions of their target mRNAs and regulate gene expression, post-transcriptionally. They play crucial roles in diverse biological processes, including cell proliferation, apoptosis, and differentiation. In the context of cancer, miRNAs are key regulators of growth, angiogenesis, metastasis, and drug resistance. MAIN BODY: This review primarily focuses on miR-939 and its expanding roles and target genes in cancer pathogenesis. It compiles findings from various investigations. MiRNAs, due to their dysregulated expression in tumor environments, hold potential as cancer biomarkers. Several studies have highlighted the dysregulation of miR-939 expression in human cancers. CONCLUSION: Our study highlights the potential of miR-939 as a valuable target in cancer diagnosis, prognosis, and treatment. The aberrant expression of miR-939, along with other miRNAs, underscores their significance in advancing our understanding of cancer biology and their promise in personalized cancer care.

Impact of Osteoporosis on Autogenous Bone Graft Resorption.

BACKGROUND: Osteoporosis is a common disorder that is characterized by decreased bone density and increased bone resorption. This bone resorption may affect the grafted bone during the maxillofacial reconstruction. PURPOSE: This study aimed to measure the association between osteoporosis and resorption of anterior iliac crest bone grafts used to reconstruct the atrophic anterior maxillae. STUDY DESIGN, SETTING, SAMPLE: This prospective cohort study included female patients requiring bone augmentation of the anterior maxilla. Patients with a ridge width of <4 mm and ridge height of >7 mm were enrolled in the study. Exclusion criteria were chronic use of corticosteroids or intravenous bisphosphonates, history of maxillofacial radiation therapy, current smoking, and underlying conditions contributing to bone metabolism (eg, hyperparathyroidism, chronic renal failure, and hypophosphatemia). PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE: Osteoporosis status was a predictor variable. Patients were allocated to the osteoporosis or control group based on T-scores obtained by dual-energy x-ray absorptiometry. Mean T-scores ≤ -2.5 were assigned to the osteoporosis group. MAIN OUTCOME VARIABLE(S): The outcome variable was graft resorption, defined as the difference in ridge width between measurements made immediately (T1) and 6 months postoperatively (T2) using cone-beam computed tomography. COVARIATES: Patient age, preoperative (T0) bone width, and the amount of bone augmentation, defined as the differences in ridge width between measurements made preoperatively (T0) and immediately after grafting (T1), were covariates of this study. ANALYSES: Descriptive, analytic, and general linear models were computed. Statistical significance was set a P < .05. RESULTS: Thirty-two patients were included in the study (15 in the osteoporosis group and 17 in the control group). The amount of graft resorption at 6 months after grafting was 2.57 ± 0.59 mm in the osteoporosis group and 0.97 ± 0.59 mm in the control group (P < .001). A significant correlation was found between the mean T-score and graft resorption 6 months after grafting (P < .001). CONCLUSION AND RELEVANCE: A significant correlation was observed between osteoporosis and graft resorption in the anterior maxilla after 6 months.

Comparing Quality of Life: Discectomy Surgery versus Epidural Corticosteroid Injection for Lumbar Disc Herniation.

BACKGROUND: Selecting an efficient treatment for patients with radiculopathy caused by lumbar disc herniation (LDH) unresponsive to conservative management remains a challenging task under investigation, yielding varying results. This study aims to compare the outcomes of the 2 most prevalent invasive treatments. METHODS: In this retrospective longitudinal study, we enrolled patients with confirmed refractory symptomatic LDH who sought treatment at Valiasr Hospital and underwent either discectomy surgery or epidural steroid injection (ESI) between 2019 and 2022. The outcome measures included pain intensity using the Visual Analog Scale (VAS) and quality of life (QoL) using the SF-36 questionnaire. RESULTS: A total of 202 individuals (112 in the discectomy group and 90 in the ESI group) consisting of 90 males and 112 females, with a mean age of 50.9 ± 13.5 years, underwent analysis. In the univariate analysis, QoL scores were significantly higher in the discectomy group (57.4 ± 2.4) compared to the ESI group (44.2 ± 2.4) (P < 0.01). Furthermore, the surgery group exhibited a significantly greater reduction in the Leg VAS score after treatment compared to the ESI group (mean difference: -2.59, 95% confidence interval (CI): -3.45 to -1.70, P < 0.01). After adjusting for the most important confounding variables using multiple linear regression analysis, the association between surgery and higher QoL scores remained statistically significant (Unstandardized Coefficients B = 7.65, 95% CI: 0.55, 14.76, P = 0.03). CONCLUSIONS: Our findings indicate that discectomy surgery has a more pronounced effect on patient outcomes and is a preferable treatment option for LDH patients.

Effects of Maxillary Movements on Lips Following Orthognathic Surgery: A Retrospective Non-Randomized Clinical Trial.

Introduction Lips play a fundamental role in facial attractiveness and in decisions pertaining to orthognathic surgery. Objective To assess the upper lip changes following Le Fort I osteotomy for maxillary advancement and/or impaction. Methods In the present retrospective non-randomized clinical trial, we evaluated 3 groups of patients who underwent Le Fort I osteotomy of the maxilla. Group 1 (n = 35) underwent maxillary advancement, group 2 (n = 14), maxillary impaction, and group 3 (n = 11) was submitted to both maxillary advancement and impaction. The lip thickness of all patients was measured preoperatively, and the participants in each group were categorized into two subgroups: thin (< 12 mm) and thick (> 12 mm) lip. The primary (before orthognathic surgery) and final (after orthodontic bracket removal) lateral cephalograms of the patients were analyzed using the Dolphin software. Comparisons were made using the paired t -test and linear regression in the IBM SPSS Statistics for Windows software. Results The length of the upper lip increased by 1 mm ( p = 0.012) on average following maxillary advancement, and it decreased by 0.43 mm ( p = 0.24) on average following maxillary impaction. In the maxillary advancement group, the change in angulation of the incisors predicted the incisal display ( p = 0.03). In the maxillary impaction group, skeletal changes in the vertical dimension predicted changes in upper lip length ( p = 0.033). Conclusions Le Fort I osteotomy for maxillary advancement significantly increases the length of the upper lip. The assessment of lip thickness prior to surgery can help predict the postoperative results. Changing the angulation of the incisors can predict the incisal display. In maxillary impaction, skeletal changes in the vertical dimension can predict the changes in the length of the upper lip.

The use of Titanium Meshes in Surgical Closure of the Oroantral Fistula. A Randomized Clinical Trial Study.

The closure of oroantral communications (OACs) is challenging. The study aimed to assess the effect of titanium meshes in the outcome of OAC closure by local flaps. This is a prospective randomized, nonblinded clinical trial. Patients with a delay and large (≥7 mm 2 ) OAC were studied. Patients were randomly divided into 2 groups: in group 1, patients underwent OAC closure through a modified Rehrmann buccal advancement flap with a titanium mesh, and in group 2, the modified Rehrmann buccal advancement flap. The primary predictive factor was the use of titanium mesh. Dehiscence (the breakdown of the edge of flaps without the complete reopening of the defect) was a primary outcome. The defect's reopening was considered a secondary outcome. Nineteen patients in group 1 and 20 in group 2 were studied. In 2 months after treatments, the prevalence of dehiscence in group 1 was 3, and 10 patients in group 2 ( P =0.041). In group 1, patients did not show OAC exposure. However, OAC exposure was observed in 2 patients in group 2. This study demonstrates that using titanium mesh in combination with a modified Rehman flap decreases the prevalence of dehiscence compared with a flap alone.

Clinical and Cephalometric Changes in Long-face Patients With Retrogenia Following the Novel B-genioplasty Technique.

BACKGROUND: The chin plays a fundamental role in facial attractiveness. Accordingly, several surgical procedures have been proposed for chin contouring. This study aimed to introduce "B-genioplasty" as a novel genioplasty technique and assess the clinical and cephalometric changes in long-face patients with retrognathia following the novel B-genioplasty. METHODS: This is a cross-sectional study. Subjects with class I occlusion increased lower facial height and retrognathia underwent B-genioplasty in this prospective experimental study. Soft and hard tissue cephalometric measurements were made, and the depth of the notch in the lower border of the mandible was measured on lateral cephalograms at 6 months postoperatively and compared with baseline. Patient satisfaction with the outcome was also assessed. RESULTS: Seventeen subjects were studied. Ten (58%) patients underwent rhinoplasty plus genioplasty. All patients were satisfied with the outcome. The step/notch in the lower border of the mandible was not detected in clinical examination in any patient. The mean notch depth was 0.5±0.83 mm on lateral cephalograms. The change in all soft and hard tissue cephalometric parameters was significant at 6 months postoperatively compared with baseline (P<0.001 for all). CONCLUSION: B-genioplasty caused satisfactory clinical and cephalometric changes in long-face patients with retrognathia, including prevention of step/notch in the inferior border of the mandible, significant reduction of gonial angle, correction of the mandibular plane, and reduction of lower facial height.

Does leucocyte- and platelet-rich fibrin enhance neurosensory recovery after genioplasty? A double-blind, split-mouth, randomised clinical trial.

Neurosensory disturbances (NSD) are common after genioplasty. In this study we aimed to assess the recovery of NSDs with or without leukocyte- and platelet-rich fibrin (L-PRF) following genioplasty. In this double-blind, split-mouth, randomised clinical trial, L-PRF was applied around the mental nerve at the osteotomy site in genioplasty (treatment side). The contralateral side was considered the control side. Two-point discrimination (TPD) test, brush test, and self-reported NSDs (SR-NSD) were used to determine NSD at one, four, and 12 months after genioplasty. Twenty patients were studied. At one and four months after osteotomy, the mean scores of TPD and SR-NSDs were significantly different between the treatment and control sides (p = 0.04, p = 0.01, respectively). The mean of TPD and SR-NSDs was not statistically different on both sides 12 months after operation (p = 0.05, p = 0.71, respectively). The application of L-PRF may enhance the speed of NSD recovery four months after genioplasty.

The Therapeutic Values of IL-7/IL-7R and the Recombinant Derivatives in Glioma: A Narrative Review.

Interleukin-7 (IL-7) is essential for maintaining the immune system's defense functions by regulating the development and homeostasis of lymphocytes. Findings have shown the high efficacy of IL-7/IL-7 receptor (IL-7R)-based immunotherapy on various malignancies, with confirmation in both animal models and humans. In recent years, the progression-free survival and overall survival of patients suffering from gliomas significantly increased by introducing C7R-expressing chimeric antigen receptor (CAR)-T cells and long-acting IL-7 agonists such as NT-I7 (rhIL-7-hyFc, Efineptakin alfa). However, the effect of IL-7-based immunotherapies on the resistance of tumor cells to chemotherapy (when used simultaneously with chemotherapy agents) is still ambiguous and requires further studies. This article first reviews the pathophysiological roles of IL-7/IL-7R in tumors, focusing on gliomas. Subsequently, it discusses the therapeutic values of IL-7/IL-7R and the recombinant derivatives in gliomas.

Restricted maternal nutrition and supplementation of propylene glycol, monensin sodium and rumen-protected choline chloride during late pregnancy does not affect muscle fibre characteristics of offspring.

BACKGROUND: Grazing in arid and semi-arid regions faces pregnant ewes with feed restrictions and hence affects the offspring muscle fibre characteristics. Using feed additives that enhance nutrient availability during foetal muscle development is expected to alter offspring skeletal muscle characteristics. OBJECTIVES: This study evaluated the effect of maternal restricted nutrition and supplementation of propylene glycol, monensin sodium and rumen-protected choline chloride on lamb's muscle fibre characteristics. METHODS: Forty-eight Ghezel ewes were randomly allocated to one of six diets (N = 8) during the last 6 weeks of gestation: ad libitum feed intake (AL); restricted feeding (RF); restricted feeding containing propylene glycol (PG); restricted feeding containing propylene glycol and monensin sodium (MS); restricted feeding containing propylene glycol and rumen-protected choline chloride (RPC); restricted feeding containing propylene glycol, monensin sodium and rumen-protected choline chloride (PMC). The muscle samples were obtained from the semitendinosus muscle of 2-week-old male lambs (n = 5/treatment) via biopsy and were stained and classified as fibre types I, IIA and IIB. RESULTS: Pre-parturient maternal feed restriction and administration of propylene glycol, monensin sodium and rumen-protected choline chloride had no significant effect on fibre-type composition, fibre density of muscle, muscle cross-sectional area and volume density of fibres (p > 0.05). CONCLUSIONS: Either maternal dietary restriction or supplementation of nutrient flux-involved additives during late pregnancy did not alter muscle fibre development and had no short-term effects on muscle properties of the resulting offspring as myogenesis occurs in early and mid-gestation, not late gestation. Therefore, maternal nutrition may not be a problematic issue in sheep production in arid and semi-arid areas.

Which factors affect the risk of membrane perforation in lateral window maxillary sinus elevation? A prospective cohort study.

It was the aim of this prospective cohort study to assess the various anatomical and other patient-related factors that increase membrane perforation risk. Patients underwent cone-beam computed tomography (CBCT) before surgery. The presence of septa, presence of mucous retention cyst, lateral wall thickness, membrane thickness, and residual bone height were predictive factors. Age, gender, and smoking were covariates for the study. The presence or absence of membrane perforation was the study outcome. In total, 140 subjects were studied. The hazard ratio (HR) for the presence of septa with membrane perforation was 8.07 (2.93-22.29) (p < 0.001). The HR for perforation with a single edentulous area relating to two or more teeth was 68.09 (9.52-49.16). The risk of membrane perforation in smokers was 25 times more than in non-smokers - HR 25 (7.58-82.51) (p < 0.001). The HR for membrane perforation in subjects with mucous retention cysts compared with subjects without retention cysts was 27.75 (8.73-88.23) (p < 0.001). Within the limitations of the study it seems that anatomical, habitual, and pathological factors may increase the risk of Schneiderian membrane perforation when a lateral window approach is used for sinus floor augmentation.

Outcomes and influential factors in functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region: a systematic review and meta-analysis.

BACKGROUND: This systematic review and meta-analysis aimed to evaluate the factors influencing and success rates of dental implants for functional and dental rehabilitation following microvascular fibula flap reconstruction in the maxillomandibular region. MAIN TEXT: We conducted a comprehensive search of electronic databases, including MEDLINE, Web of Science, Embase, Scopus, and Cochrane's CENTRAL, as well as gray literature sources and manual searches of notable journals. The search was performed from inception until February 2023. Studies were included if they examined functional and dental rehabilitation outcomes in patients receiving maxillofacial reconstruction using microvascular fibula flaps and were retrospective or prospective cohort studies involving human subjects. Case-control studies, research involving other reconstruction methods, and animal-based studies were excluded. Data was extracted and confirmed by two independent researchers, and risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analyses were conducted for dental implant and graft success rate, with separate analyses for different factors affecting the outcome. Heterogeneity was evaluated using Cochran's Q test and the I2 test. The pooled success rate for implants was 92% and for grafts, 95%, with significant heterogeneity. Implants in fibular grafts had a 2.91 times higher failure rate than those in natural bones. Radiated bone and smoking were identified as factors influencing implant failure, with radiated bone having a 2.29 times higher risk and smokers having a 3.16 times higher risk compared to their respective counterparts. Patient-reported outcomes showed improvements in key areas such as dietary intake, mastication, speech, and esthetics. The success rates declined over time, emphasizing the importance of long-term follow-up. CONCLUSIONS: Dental implants in free fibula grafts generally have favorable success rates, with minimal bone resorption, manageable probing depths, and limited bleeding on probing. Implant success is influenced by factors such as smoking and radiated bone.

Investigating the effect of insertion torque on marginal bone loss around dental implants.

BACKGROUND/PURPOSE: The use of dental implants in restoring function, esthetics, speech, and health of oral tissues has been growing in recent years. Evaluating marginal bone resorption and the survival rate of implants placed with different torques values is crucial. The primary aim of the present study was to evaluate the effect of different insertion torque values on marginal bone loss around dental implants placed in the posterior region of the mandible. MATERIALS AND METHODS: 37 patients were involved in this study. Patient data (age, gender), implant characteristics (length, diameter), insertion torque values, gingival biotype, and bone quality were recorded, and parallel periapical radiographs measured marginal bone loss. The relationship between variables was obtained using independent t-tests, Pearson correlations, and regressions. RESULTS: The present study found a positive and significant correlation between implant insertion torque and marginal bone loss (MBL)around the dental implants during the first year after placement. Furthermore, patients with D2 bone density at the implant placement site and thin gingival biotype also had significantly higher MBLs from baseline until crown delivery and first-year follow-up than those with D3 bone density and thick gingival biotypes, respectively. CONCLUSION: A lower torque is necessary for high-risk patients to increase implantation success due to identifying patients with an increased risk for MBL.

How does the Number of Implants Affect Stress Distribution in Fibula Graft at the Posterior of the Mandible? A Finite Element Analysis.

Objectives: Evidence about the implant protocol and success in the osseous microvascular grafts is not sufficient. Stress distribution around dental implants is one of the important factors determining treatment success. The purpose of this study was to evaluate stress distribution in the bone supporting the implants inserted in the fibula free flap, in patients with large defects in the posterior of the mandible by finite element analysis (FEA). Materials and Methods: The CBCT was obtained from one patient with fibula free flap in the posterior of the mandible and also from a 4.1 × 10 mm implant (Zimmer, Zimmer dental, Carlsbad, USA). Two 3D finite models were designed containing three or four implants. The implants were splinted by a suprastructure. Vertical load (300 N) and oblique load (50 N) were applied to the suprastructure. The von Mises stress distribution and the micromotion of implants were evaluated. Results: No significant difference was observed between implants micromotion in two models. According to stress distribution analysis and determining maximum stress regions, the model with four implants imposes more stress on titanium components and surrounding bone. Conclusion: The stress distribution around the implants of mandibular models with posterior defect that was reconstructed with fibula free flap is better in models with three fixtures versus four fixtures.

The association between nonalcoholic fatty liver disease and corrected QT interval prolongation among generally healthy Iranian population: Fasa Cohort Study (FACS).

BACKGROUND: There are limited studies about the association between nonalcoholic fatty liver disease (NAFLD) and corrected QT interval (QTc) prolongation worldwide. HYPOTHESIS: Therefore, we designed the current study to determine this association in a large cohort of a generally healthy population. METHODS: We analyzed the data of 4603 individuals aged 35-70 who participated in the Fasa Cohort Study (FACS). Based on 12-lead electrocardiograms, QT intervals were calculated and corrected by Bazzet's formula. A QTc interval of more than 430 ms in men and 450 ms in women was considered prolonged. The Fatty Liver Index was used to identify the participants with NAFLD. RESULTS: Of all participants, 1550 (33.6%) met the NAFLD criteria. In subjects of both genders with NAFLD, the mean values of the QTc interval were considerably higher than in those without NAFLD (p < .001). After adjusting for a wide range of confounders, including age, gender, smoking status, physical activity, total cholesterol, high-density lipoprotein-cholesterol levels, diabetes, and hypertension status, in linear regression analysis, the standardized ß coefficient of QTc interval among participants with NAFLD was 2.56 ms (95% confidence interval [CI]: 0.49-4.64). After controlling the same confounders, the odds ratio of NAFLD for a prolonged QTc interval in men was 1.47 (95% CI: 1.18-1.84; p < .001) and in women was 1.39 (95% CI: 1.15-1.68; p < .001) using logistic regression analysis. CONCLUSIONS: NAFLD was a risk factor for QTc interval prolongation. Awareness about the risk of NAFLD in increasing the potential cardiac arrhythmias should be raised to lower cardiac mortality.

Sleep disturbance and gastrointestinal cancer risk: a literature review.

Sleep, accounting for roughly one-third of a person's life, plays an important role in human health. Despite the close association between sleep patterns and medical diseases proven by several studies, it has been neglected in recent years. Presently, all societies are facing the most challenging health-threatening disease, cancer. Among all cancer types, gastrointestinal (GI) cancers, especially colorectal type, seem to be one of the most relevant to an individual's lifestyle; thus, they can be prevented by modifying behaviors most of the time. Previous studies have shown that disruption of the 24-h sleep-wake cycle increases the chance of colorectal cancer, which can be due to exposure to artificial light at night and some complex genetic and hormone-mediated mechanisms. There has also been some evidence showing the possible associations between other aspects of sleep such as sleep duration or some sleep disorders and GI cancer risk. This review brings some information together and presents a detailed discussion of the possible role of sleep patterns in GI malignancy initiation.