ABSTRACT
Metastatic non-small cell lung cancer (NSCLC) poses a significant clinical challenge, prompting a focused investigation into the role of KRAS mutations in prognosis and treatment response. Targeted therapies offer promising avenues for intervention, motivating a comprehensive analysis of existing evidence. Conducted in June 2023, our review delved into MEDLINE (Medical Literature Analysis and Retrieval System Online), Embase, Scopus, and the Cochrane Register of Controlled Trials. Rigorous inclusion and exclusion criteria guided the selection of 12 articles, comprising two randomized controlled trials (RCTs) and 10 observational studies. Multiple investigators independently executed data extraction, evaluating prognostic factors (overall and progression-free survival) and predictive outcomes (treatment and objective response). The Newcastle-Ottawa Scale (NOS) and modified Jadad scores were used for study quality assessment of observational studies and RCTs, respectively. From an initial pool of 120 articles, the 12 selected studies, spanning 2013 to 2022, encompassed 2,845 metastatic NSCLC patients. KRAS mutations, particularly the G12C variant, emerged as a pivotal factor influencing treatment response. Notably, KRAS wild type patients displayed enhanced responses to platinum-based chemotherapy, while those with KRAS mutations exhibited favourable outcomes with immune checkpoint inhibitors (ICIs). The role of KRAS mutations as prognostic indicators in metastatic NSCLC is underscored by this systematic review, with implications for both survival and treatment response. The discernment between KRAS wild type and mutant patients offers insights into tailored therapeutic strategies, with platinum-based chemotherapy and immune checkpoint inhibitors emerging as context-dependent options. Nevertheless, more research is required to solidify the predictive role of KRAS and explore the efficacy of KRAS inhibitors and other targeted therapies, paving the way for refined and personalized interventions in the management of metastatic NSCLC.
ABSTRACT
Background: Although glass-ionomer cement (GIC) has many unique properties and advantages, it still lacks favorable mechanical properties. Cention N is a recent alkasite material with excellent mechanical properties. The purpose of this study was to compare the mechanical properties (fracture toughness [FT] and flexural strength [FS]) and acid buffer capability of an alkasite material to GIC. Materials and Methods: In this in vitro study, a total of 60 samples were prepared using Cention N or GIC. Twenty specimens (n = 10) were prepared using beam-shaped Teflon molds for FS, and twenty specimens (n = 10) were prepared with a similar mold with a notch for FT. These were evaluated on a universal testing machine using a three-point bend test. Twenty (n = 10) disk-shaped specimens were prepared for acid buffer capability. The samples were stored in distilled water for a week. This was followed by immersion in lactic acid with a pH of 4 for calculation of the materials acid buffering capacity at 30 and 60 min from exposure using a pH meter. The data obtained were tabulated and subjected to Kolmogorov-Smirnov test and Shapiro-Wilk test to assess the normal distribution and further analyzed using the Student's t-test to assess the level of significance, P < 0.05 was considered statistically significant. Results: The mean FT, FS, and acid buffer capability of Cention N were significantly higher than GIC at P < 0.05. Conclusion: The present study surmised that Cention N exhibited higher FT, FS, and acid buffer capability than GIC.
ABSTRACT
This article reports nonsurgical endodontic management of bilateral maxillary first molars with an unusual morphology of a single root and a Sert and Bayirli type-IX canal configuration. A 41-year-old female reported with dull continuous pain in the maxillary left and right quadrants. On clinical examination, the maxillary first molars on both sides were carious with pulpal exposure and radiographic evaluation revealed an unusual anatomy of single root and single canal for both of them. Based on clinical and radiographic examination, tooth numbers 16 and 26 were diagnosed with symptomatic irreversible pulpitis and symptomatic apical periodontitis. Root canal treatment was initiated and cone-beam computed tomography (CBCT) imaging was advised on encountering unusual internal anatomy. The CBCT images revealed the presence single root and a Sert and Bayirli type-IX canal configuration bilaterally. Root canal treatment was performed under magnification using the dental operating microscope.