The effects of severe periodontitis on arterial stiffness using cardio-ankle vascular index in patients with type 2 diabetes.

BACKGROUND AND OBJECTIVE: Arterial stiffness, which is a measure of the elasticity of the arteries, is also a risk factor for the development of cardiovascular diseases and its measurement is important for evaluating the atherosclerosis process. The purpose of this cross-sectional study to investigate whether severe periodontitis in short-term type 2 diabetes may be associated with increased cardio-ankle vascular index (CAVI) values specified for subclinical atherosclerosis risk. METHODS: A total of 136 subjects, including 69 subjects with short-term type 2 diabetes (35 with severe periodontitis and 34 with periodontally healthy) and 67 systemically healthy subjects (32 with severe periodontitis and 35 with periodontally healthy) were enrolled to this study. Assessment of all participants included in this study in terms of arterial stiffness was determined by CAVI. Serum fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), triglyceride (TRG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC) and C-reactive protein (CRP) levels were calculated using standard methods. Full mouth periodontal measurements were recorded. Multiple linear regression analysis was performed to evaluate the relationship between periodontal parameters and mean CAVI values of the groups. RESULTS: Mean CAVI levels were significantly higher in diabetic and periodontitis group compared to the other study groups (p < .05). In diabetes and periodontitis group, CAVI was showed positive correlations with CRP (r = .337, p = .048) and HbA1c (r = .442, p = .008). Also, positive significant correlations were found with probing depth (PD) and clinical attachment level (CAL) in the periodontitis groups. Multiple regression analysis revealed that CAL independently predicted CAVI levels in periodontitis groups (ß = .433, p = .019 in diabetes and periodontitis groups and ß = .57, p = .001 in systemically healthy and periodontitis group respectively). CONCLUSION: This is the first study investigating the association between severe periodontitis and CAVI in patients with short-term diabetes. Our findings suggest that severe periodontitis may be an intermediate factor in the pathway between type 2 diabetes and cardiovascular disease by increasing the arterial stiffness.

Is a two-hour monitoring period sufficient and safe for patients undergoing ultrasound-guided percutaneous liver mass biopsy?: A prospective and multicenter experience.

PURPOSE: To investigate whether patients undergoing percutaneous liver mass biopsy (PLMB) can be safely discharged following a two-hour monitoring period. METHODS: A multi-center prospective analysis was conducted for 375 patients (196 males and 179 females), mean age 63 ± 12.45 years (range 37-89) who underwent PLMB between August 2023 and March 2024. Patients were monitored for 24 h, and complications were classified as minor or major. The timing of complications was categorized into three groups: within the first two hours, between the 2nd and 24th hours, and within 1 week after 24 hours. RESULTS: Minor complications occurred in 18.93% (71/375) and major complications in 2.13% (8/375). Most minor complications (80.2%, 57/71) appeared within the first two hours, 12.7% (9/71) between 2 and 24 h, and 7.1% (5/71) after 24 h. All major complications (62.5%, 5/8) except late-onset cases, occurred within the first two hours. No major complications occurred between 2 and 24 h. Late-onset major complications occurred in 37.5% (3/8) after 24 h. CONCLUSION: The two-hour monitoring period did not adversely impact patient management regarding minor complications and is safe for identifying all major complications except for late-onset ones. Extending the post-biopsy recovery period does not significantly improve patient care.

Reliability, diagnostic value, and diagnostic yield of ultrasound-guided percutaneous core needle biopsy for peritoneal lesions.

INTRODUCTION: Peritoneal lesions cannot be definitively distinguished based on clinical and imaging characteristics alone. This study aimed to evaluate the reliability, diagnostic value, and diagnostic yield of ultrasound-guided percutaneous core needle biopsy (PCNB) for peritoneal lesions. METHODS: A retrospective analysis of 129 patients who underwent PCNB for peritoneal lesions was performed to assessed technical completion and diagnostic yield. RESULTS: The results showed that ultrasound-guided PCNB is a safe and reliable diagnostic tool with high diagnostic yield for peritoneal lesions. Technical feasibility and diagnostic yield rates were 100% and 89.9%, respectively. The diagnostic yield was lower for patients with a known history of cancer and a short anteroposterior diameter of the target lesion. CONCLUSIONS: These findings suggest that ultrasound-guided PCNB could be considered as a first-line diagnostic tool for peritoneal lesions, as it offers a minimally invasive and accurate means of obtaining tissue samples for diagnosis.

Can PET/CT be used more effectively in pleural effusion evaluation?

PURPOSE: Sometimes, characterization of pleural effusion (PE) can be challenging especially in patients whom invasive procedures/recurrent invasive procedures cannot be performed. The main purpose of the study is to answer this question, Can 18F-FDG-PET/CT contribute to reduction in the number of invasive procedures or patients undergoing to invasive procedures? Results may increase the effectiveness of patient management by facilitating clinical decision-making, especially in patients who cannot undergo invasive/recurrent invasive procedures. METHODS: Sixty-seven patients' 18F-FDG-PET/CT, pleural fluid cytologies (PFCs) and, if any, pleural biopsies were re-assessed. If patient's PFC/biopsy was malignant, effusion was considered as malignant. If two consecutive PFCs were negative in patients without biopsy, effusion was considered as benign. Characterization was based on consensus with baseline/follow-up 18F-FDG-PET/CT and clinical parameters in patients with one negative PFC (n = 6). RESULTS: None of the 18F-FDG-PET/CT parameters could characterize PE alone. However, if PE maximum standardized uptake value (SUVmax) > 1.3 or PE SUVmax/mean standardized uptake value of mediastinal blood pool (MBP SUVmean) > 1.2 was combined with at least one of the following, specificity and positive predictive value (PPV) were 100%, accuracy was around 90%. Diffuse-nodular/nodular pleural thickness, post-obstructive atelectasis, nodule/mass with SUVmax > 2.5 in lung, multiple pulmonary nodules. All 29 patients who had SUVmax > 1.3 together with at least one of the mentioned four parameters diagnosed malignant pleural effusion (MPE). However, sensitivity and negative predictive value (NPV) were still insufficient. CONCLUSION: Patients who have contraindications for invasive diagnostic methods, and meet the aforementioned criteria may be considered as MPE primarily. On the other hand, if PE SUVmax < 1.3 or PE SUVmax/MBP SUVmean < 1.2 with the negativity of the all four parameters mentioned above, it is difficult to say that this can be considered as benign pleural effusion (BPE) according to our results.