Comparison of efficacy of pharmacological cardioversion with antazoline and propafenone versus electrical cardioversion in atrial fibrillation during cryoablation.

Introduction: Antazoline with propafenone may be an alternative to electrical cardioversion (ECV) in restoring sinus rhythm in patients with atrial fibrillation (AF), including during balloon cryoablation. Aim: To compare the efficacy of antazoline with propafenone and ECV in restoring and maintaining sinus rhythm at discharge in patients with AF during cryoablation with special regard to type of AF. Material and methods: The study retrospectively analyzed 196 patients who underwent elective cryoablation. Eighty-nine patients who developed AF in the perioperative period were selected as the study group (32 women and 57 men). The study group was divided into two groups - 46 (51.7%) patients were given pharmacological cardioversion with 70 mg of propafenone and 100 or 200 mg of antazoline, whereas the other 43 (48.3%) patients underwent ECV. Results: There were no statistically significant differences between the groups regarding: left atrial area, left atrium diameter, right atrial area and right atrium diameter. In the overall population, ECV was more effective than antazoline with propafenone therapy (31 [72.1%] vs. 20 [43.5%]; p = 0.01). A similar relationship was demonstrated in patients with persistent AF (13 [59.1%] vs. 3 [12.5%]; p = 0.002). There was no significant difference in the group of patients with paroxysmal AF (18 (85.6%) vs. 17 (77.3%); p = 0.7). Conclusions: In AF during the cryoablation procedure ECV appears to be more effective in restoring and maintaining sinus rhythm at discharge than antazoline with propafenone in the general AF patient population, especially in patients with persistent AF.

Gestational Diabetes Mellitus and Colostral Appetite-Regulating Adipokines.

Gestational diabetes mellitus (GDM) is a complex metabolic disorder that has short- and long-term effects on maternal and offspring health. This study aimed to assess the impact of maternal hyperglycemia severity, classified as GDM-G1 (diet treatment) and GDM-G2 (insulin treatment) on colostral appetite-regulating molecules. Colostrum samples were collected from hyperglycemic (N = 30) and normoglycemic (N = 21) mothers, and the concentrations of milk hormones were determined by immunoenzymatic assay. A difference was found for milk ghrelin, but not for molecules such as adiponectin, leptin, resistin, or IGF-I levels, in relation to maternal hyperglycemia. The colostral ghrelin in the GDM-G1 cohort (0.21 ng/mL) was significantly lower than for GDM-G2 (0.38 ng/mL) and non-GDM groups (0.36 ng/mL). However, colostral resistin was higher, but not significantly, for GDM-G1 (13.33 ng/mL) and GDM-G2 (12.81 ng/mL) cohorts than for normoglycemic mothers (7.89 ng/mL). The lack of difference in relation to hyperglycemia for milk leptin, adiponectin, leptin-adiponectin ratio, resistin, and IGF-I levels might be the outcome of effective treatment of GDM during pregnancy. The shift between ghrelin and other appetite-regulating hormones might translate into altered ability to regulate energy balance, affecting offspring's metabolic homeostasis.

Blended intensive programme's implementation in dental education: post-pandemic evolution of learning.

Blended Intensive Programmes (BIP's) represent a valuable tool for gathering knowledge and summarising the latest trends in medicine and dentistry. Blended education has been found, even before the COVID-19 pandemic, to increase the level of education and stimulate effective learning for postgraduate healthcare professionals. Interprofessional education is critical for preparing students to enter the health workforce, where teamwork and collaboration are important competencies. This article outlines the key points of the Blended Intensive Programme's implementation in dental education organised by Wroclaw Medical University in Poland. BIP involved professors from 12 universities or research institutions from Europe and South America and 28 participants from 8 countries. The course was taught remotely and in person. In addition, it included a visit to the university and practical classes with artificial simulation and practice in dentistry. A structured questionnaire enabled measuring the evaluation of students' perception of the COVID-19 education before and after the pandemic. The European Region Action Scheme for the Mobility of University Students (ERASMUS) was fundamental to carrying out the BIP with the participation of several countries, allowing the exchange of knowledge, assessing the impact of the pandemic on dental universities, and strengthening international collaborations and the future project of research, education and clinical assistance. We conclude that hybrid teaching programmes broaden the learning spectrum in dental studies by allowing transnational and interdisciplinary approaches that make students aware of the importance of their work within the framework of the general health approach, as this differs from country to country.

Orthodontic treatment demand for fixed treatment and aligners among young adults in middle Europe and South America - a questionnaire study.

BACKGROUND: Patients experiencing any malocclusion, may desire for treatment. However, there is no scientific information orthodontic treatment demand and the knowledge of young adults about orthodontic treatment. The aim of the study was to assess orthodontic treatment demand in young adults from Poland and Chile, their previous orthodontic experience and their knowledge on fixed and aligner orthodontic treatment. METHODS: The target group comprised people aged 18-30. The sample size was estimated as above 400 for each country. The survey was carried out in Polish and Spanish within 3 months and consisted of 25 questions delivered via social media. Comparisons were made between countries, age subgroups and gender. RESULTS: The response rate was 1,99%, what stands for 1092 responses, 670 from Chile and 422 from Poland, respectively. The percentage of young adults who were already treated was 42,9% in Poland and 25,0% in Chile. The ones planning to have orthodontic treatment within a year counted for 11,8% in Poland and 5,3% in Chile. Most young adults who want to be treated (20,6%) rely on doctor's recommendation on type of appliance while 14,7% of all respondents are interested solely in aligners. Most respondents have heard about aligners (58%). Direct provider-to-customer service without a doctor is not acceptable, neither in Poland (85,1%) nor in Chile (64,8%). Most young adults provided incorrect answers referring various aspects of aligner treatment. CONCLUSIONS: In both countries, patients demand to be treated and monitored by the orthodontist. A high percentage of patients want to be treated exclusively with aligners. Direct-to-consumer orthodontics does not seem attractive to patients. Young adults do not have adequate knowledge referring to aligner treatment. Many people want to be treated despite a previous orthodontic treatment.

Del Nido vs. Cold Blood Cardioplegia for High-Risk Isolated Coronary Artery Bypass Grafting in Patients with Reduced Ventricular Function.

INTRODUCTION: The evidence for using del Nido cardioplegia protocol in high-risk patients with reduced ejection fraction undergoing isolated coronary surgery is insufficient. METHODS: The institutional database was searched for isolated coronary bypass procedures. Patients with ejection fraction < 40% were selected. Propensity matching (age, sex, infarction, number of grafts) was used to pair del Nido (Group 1) and cold blood (Group 2) cardioplegia patients. Investigation of biomarker release, changes in ejection fraction, mortality, stroke, perioperative myocardial infarction, composite endpoint (major adverse cardiac and cerebrovascular events), and other perioperative parameters was performed. RESULTS: Matching allowed the selection of 45 patient pairs. No differences were noted at baseline. After cross-clamp release, spontaneous sinus rhythm return was observed more frequently in Group 1 (80% vs. 48.9%; P=0.003). Troponin values were similar in both groups 12 and 36 hours after surgery, as well as creatine kinase at 12 hours. A trend favored Group 1 in creatine kinase release at 36 hours (median 4.9; interquartile range 3.8-9.6 ng/mL vs. 7.3; 4.5-17.5 ng/mL; P=0.085). Perioperative mortality, rates of myocardial infarction, stroke, or major adverse cardiac and cerebrovascular events were similar. No difference in postoperative ejection fraction was noted (median 35.0%; interquartile range 32.0-38.0% vs. 35.0%; 32.0-40.0%; P=0.381). There was a trend for lower atrial fibrillation rate in Group 1 (6.7% vs. 17.8%; P=0.051). CONCLUSION: The findings indicate that del Nido cardioplegia provides satisfactory protection in patients with reduced ejection fraction undergoing coronary bypass surgery. Further prospective trials are required.

Fixed appliances orthodontic therapy as a risk factor for caries development: Systematic review.

Orthodontic treatment is often mandatory to improve the patient's health condition. However, the fixed appliance can create additional plaque retention areas, which can increase the risk of caries development. Clinically, one can observe various effects of fixed appliance treatment on caries prevalence. This study aims to analyze to what extent orthodontic therapy with fixed appliances is a risk factor for developing caries in pediatric and adult patients. The keywords used in the search strategy were as follows: ("caries" AND "caries risk" AND "caries experience" AND" "orthodontic treatment" OR "fixed appliance" ") and ("caries experience" AND "orthodontic treatment").From 808 potential articles, 15 were included in the review. In individuals undergoing fixed orthodontic therapy, several factors can increase the risk of car-ies during fixed orthodontic treatment, such as salivary composition, oral dysbiosis and plaque accumulation. On the other hand, factors that reduce caries risk are, i.e., oral hygiene self-awareness and previous orthodontic treatment. In most studies which used the Decayed, Missing, and Filled Teeth (DMFT) index, there were no significant differences between the values obtained before orthodontic treatment and after the treatment. Moreover, it is easier for a patient with aligned teeth to remove plaque.In the young population, fixed orthodontic treatment appears to reduce the incidence of caries. In the adult population, fixed orthodontic treatment increases the risk of dental caries. However, education on proper oral hygiene during orthodontic treatment can reduce the risk of dental caries. The study protocol was registered in the PROSPERO database [PROSPERO CRD42022356628].

Del Nido vs. Cold Blood Cardioplegia for High-Risk Isolated Coronary Artery Bypass Grafting in Patients with Reduced Ventricular Function

ABSTRACT Introduction: The evidence for using del Nido cardioplegia protocol in high-risk patients with reduced ejection fraction undergoing isolated coronary surgery is insufficient. Methods: The institutional database was searched for isolated coronary bypass procedures. Patients with ejection fraction < 40% were selected. Propensity matching (age, sex, infarction, number of grafts) was used to pair del Nido (Group 1) and cold blood (Group 2) cardioplegia patients. Investigation of biomarker release, changes in ejection fraction, mortality, stroke, perioperative myocardial infarction, composite endpoint (major adverse cardiac and cerebrovascular events), and other perioperative parameters was performed. Results: Matching allowed the selection of 45 patient pairs. No differences were noted at baseline. After cross-clamp release, spontaneous sinus rhythm return was observed more frequently in Group 1 (80% vs. 48.9%; P=0.003). Troponin values were similar in both groups 12 and 36 hours after surgery, as well as creatine kinase at 12 hours. A trend favored Group 1 in creatine kinase release at 36 hours (median 4.9; interquartile range 3.8-9.6 ng/mL vs. 7.3; 4.5-17.5 ng/mL; P=0.085). Perioperative mortality, rates of myocardial infarction, stroke, or major adverse cardiac and cerebrovascular events were similar. No difference in postoperative ejection fraction was noted (median 35.0%; interquartile range 32.0-38.0% vs. 35.0%; 32.0-40.0%; P=0.381). There was a trend for lower atrial fibrillation rate in Group 1 (6.7% vs. 17.8%; P=0.051). Conclusion: The findings indicate that del Nido cardioplegia provides satisfactory protection in patients with reduced ejection fraction undergoing coronary bypass surgery. Further prospective trials are required.

SARS CoV-2 IgG seropositivity post-vaccination among dental professionals: a prospective study.

BACKGROUND: The COVID-19 pandemic has spread very rapidly around the world. Various regional and national lockdowns were imposed to control the spread. Meanwhile, vaccine development and population vaccination were the next steps for pandemic control. Workers in the dental field, both dentists and dental assistants, however, were close to the sources of aerosol generated during dental procedures and thus were the group of workers the most exposed to COVID-19 infection. The aim of our study was to monitor the immune response before and after the vaccine in a high-risk population, composed by dental professionals. METHODS: A clinical prospective study was carried out among dental professionals at the Academic Dental Polyclinic, Wroclaw Medical University (Wroclaw, Lower Silesia region, Poland). Blood samples were collected at an interval of one year - March/April 2020, before the vaccination against COVID-19, and April 2021, after the vaccination. The analysis was performed on serum with four different methods: qualitative, semi-quantitative, and quantitative IgG count for SARS-CoV-2, and SARS-CoV-2 neutralizing antibodies. RESULTS: A total of 42 healthy adult volunteers participated in the study. The results showed a statistically significant difference (p < 0.05) in antibody levels before and after vaccination (1st and 2nd measurement) for each test method. The tests that were used affected the results and the test that showed the strongest relationship with the result was the Qualitative test. CONCLUSIONS: Dental professionals are the adult working population most at risk for COVID-19. Monitoring SARS-CoV-2-status-related seropositivity can provide useful information occupational risk factors for dental professionals.

Determinants of Inadequate Cardioprotection in Adult Patients with Left Ventricular Dysfunction.

BACKGROUND: Perioperative cardioprotection is essential for achieving satisfactory clinical outcomes in heart failure patients. It is important to understand the factors affecting perioperative cardioprotection. METHODS: The institutional database was searched for patients with reduced ejection fraction (EF, < 40%) who underwent surgery with cardioplegia-induced arrest. Patients were divided into del Nido cardioplegia (DN) and cold blood cardioplegia (CB) groups. The relationships between age, preoperative blood parameters, creatinine, cross-clamp time (CCT), extracorporeal circulation time (ECT), and postoperative troponin values at 12 hours or deterioration of EF (≥5%) were evaluated. Baseline characteristics, operative parameters, and outcomes were analyzed. RESULTS: There were 508 patients with reduced EF (331 DN and 177 CB). In the entire cohort, anemic patients had greater troponin values (p = 0.004) as well as in the DN group (p = 0.002). However, this was not detected in the CB group (flat regression line; p = 0.674). Patients with high leukocyte values had greater troponin release (entire cohort: p < 0.001; DN group: p < 0.001; CB group: steep regression line with p = 0.042). Longer CCT and ECT were associated with greater troponin release (entire cohort; both groups) and greater risk of fall in EF. In a direct comparison, fewer patients had significant deterioration of EF in the DN group than CB group (3.9 vs. 11.9%; p < 0.001). CONCLUSION: The use of CB cardioplegia may be beneficial in anemic patients, whereas the use of DN cardioplegia may be beneficial for expected long CCT and high leukocytosis.

Efficacy of ozonated water as a PS in photodynamic therapy: A tool for dental caries management? An in vitro study.

Background: The most prevalent noncommunicable disease in the world is dental caries; and when it is not adequately treated, it is usually associated with tooth loss or severe dental lesions. In fact, expensive care or tooth extraction may be necessary due to the negative effects dental caries have on general health. This is due to its frequent pain and secondary bacterial infections. The aim of this study was to investigate the activity of ozonated water as such and in combination with appropriate light radiation so as to perform a photodynamic treatment (PDT) against the cariogenic bacterium Streptococcus mutans. Design and methods: This work has been performed in vitro by using an S. mutans strain mainly structured in a biofilm status, reproducing the natural condition of the tooth infection. The ozone was tested at three different concentrations by using a commercial device able to generate different O3 formulations in water. The PDT treatment requires an appropriate light wavelength, evaluated in this work through the UV-Vis adsorption spectrum of the ozonated water. Results: The obtained results suggested an effective and synergic property of O3 and light at 460-470 nm against this microorganism. The most antibiofilm activity was observed using a concentration of ozone of 0.06 mg/L alone as well as with PDT treatment. Conclusions: The results are encouraging for additional research and in vitro/in vivo fresh experimental investigations to perform an exhaustive antimicrobial treatment protocol against the S. mutans tooth infection.

MIH and Dental Caries in Children: A Systematic Review and Meta-Analysis.

(1) Background: Molar-incisor hypomineralization (MIH) is a clinical condition affecting permanent teeth in children, with a documented rising trend in the last two decades. The aim of the present study was to analyze and synthesize the available evidence on caries experience (dmft/DMFT) and MIH in children. (2) Methods: A systematic review and meta-analysis were conducted according to the PRISMA statement. (3) Results: 59 papers published between 2007 and 2022 were included in the qualitative synthesis and 18 in the meta-analysis. The total sample of subjects was 17,717 (mean: 896), of which 2378 (13.4%) had MIH (mean: 119), with a girl/boy ratio of 1:1. The mean age of the enrolled participants was 8.6 (age range 7-10 years). Meta-analysis showed that MIH has a positive correlation with both dmft (effect size of 0.67, 95% CI [0.15, 1.19]) and DMFT (effect size of 0.56, 95% CI [0.41, 0.72]); (4) Conclusions: Children with MIH should be diagnosed correctly and on time. Treatment and management options for moderate and severe forms of MIH should consider prognosis based on known risk factors, and secondary and tertiary prevention policies should also consider the multifactorial nature of caries etiology.

Platelet-rich plasma and platelet-rich fibrin in oral surgery: A narrative review.

Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are biological products derived from the plasma fraction of autologous blood that have a platelet concentration above that of the original blood. Cytokines and growth factors are present in platelet-based preparations, and their application has gained great attention in dentistry. The aim of this review was to comprehensively examine the latest scientific evidence on the use of PRF and PRP in oral surgery, and to describe current operational protocols. Platelet-rich fibrin is used after third molar extractions, in the treatment of alveolar osteitis and trismus, and in implant surgery. Platelet-rich plasma is utilized in sinus lift procedures, after tooth extractions, and in patients undergoing the treatment of bisphosphonate-related osteonecrosis of the jaw. Based on this review, plenty of data indicates that the PRF-PRP usage in oral surgery shows promising results. However, no consistent protocols have been presented in the analyzed articles. Further research is needed to provide clinicians with evidence-based clinical recommendations and to develop protocols on the use of these preparations in dental surgery.

Long-term outcomes of the Coordinated Care Program in Patients after Myocardial Infarction (KOS-MI).

BACKGROUND: The Coordinated Care in Myocardial Infarction Program (KOS-MI) was introduced to improve prognosis for patients after myocardial infarction (MI). The program includes complete revascularization followed by unrestricted access to rehabilitation, electrotherapy and cardiac care. AIM: The aim of this study was to assess major adverse cardiac and cerebrovascular events (MACCE) of patients enrolled in the KOS-MI at 3-year follow-up. METHODS: This is a retrospective, multicenter registry of patients treated for MI. Study group (KOS-MI) of 963 patients was compared to the control group (standard of care) of 1009 patients. At 3-year follow-up MACCE including death, MI, stroke and repeated revascularization were reported. Additionally, hospitalization due to heart failure (HF) was analyzed. Propensity score matching (PSM) was utilized for group baseline characteristics adjustment. RESULTS: Patients in the KOS-MI group were younger (65 vs. 68; P < 0.001), mostly men (70% vs. 62.9%; P < 0.001), admitted with ST-elevation myocardial infarction (STEMI) (44.6% vs. 36.2%; P < 0.001). Patients in the control group had more comorbidities and were admitted more often with non ST-elevation myocardial infarction (63.8% vs. 55.4%; P < 0.001) and acute HF (5.1% vs. 2.7%; P = 0.007). Following PSM 530 well matched pairs were selected. At three years (92.3% follow-up completeness), the relative risk reduction was: 25% in MACCE (P = 0.008), 38% in mortality (P = 0.008), 29% in repeated revascularization(P = 0.04) and 28% (P = 0.0496) in hospitalization for HF in the KOS-MI group. CONCLUSIONS: The combination of contemporary invasive techniques, complete revascularization, cardiac rehabilitation and ambulatory care included in the KOS-MI Program improves long-term prognosis of patients after MI up to 3-year follow-up.

Attachments for the Orthodontic Aligner Treatment-State of the Art-A Comprehensive Systematic Review.

BACKGROUND: In recent years the burden of aligner treatment has been growing. However, the sole use of aligners is characterized by limitations; thus attachments are bonded to the teeth to improve aligner retention and tooth movement. Nevertheless, it is often still a challenge to clinically achieve the planned movement. Thus, the aim of this study is to discuss the evidence of the shape, placement and bonding of composite attachments. METHODS: A query was carried out in six databases on 10 December 2022 using the search string ("orthodontics" OR "malocclusion" OR "Tooth movement techniques AND ("aligner*" OR "thermoformed splints" OR "invisible splint*" AND ("attachment*" OR "accessor*" OR "auxill*" AND "position*"). RESULTS: There were 209 potential articles identified. Finally, twenty-six articles were included. Four referred to attachment bonding, and twenty-two comprised the influence of composite attachment on movement efficacy. Quality assessment tools were used according to the study type. CONCLUSIONS: The use of attachments significantly improves the expression of orthodontic movement and aligner retention. It is possible to indicate sites on the teeth where attachments have a better effect on tooth movement and to assess which attachments facilitate movement. The research received no external funding. The PROSPERO database number is CRD42022383276.

Friedman Tongue Position and the Anthropometric Parameters in Adult Patients with Obstructive Sleep Apnea: An Observational Study.

INTRODUCTION: Obstructive Sleep Apnea Syndrome (OSAS) is a relevant public health problem; dentists can play an important role in screening patients with sleep disorders by using validated tools and referring patients to a specialist, thereby promoting an interdisciplinary approach. The aim of the study is to identify if the OSAS severity, measured by the apnea-hypopnea index (AHI), and some anthropometric measurements are associated with the Friedman Tongue Position (FTP) within a population with dysmetabolic comorbidities. MATERIALS AND METHODS: A questionnaire containing information about clinical data including height, weight, Body Mass Index (BMI), neck circumference, waist circumference, hip circumference and FTP was administered. The AHI value was measured by means of an unattended home polysomnography device. Pearson correlation coefficients were calculated, and Kruskal-Wallis, Kolmogorov-Smirnov (both nonparametric) and independence tests were performed to probe the possible relationships. The significance was set at p ≤ 0.05. RESULTS: A total of 357 subjects were analyzed. The association between the FTP and AHI was not statistically significant. On the contrary, the AHI showed a positive correlation with BMI and neck circumference. A statistically significant association between the number of subjects with a larger neck and an increasing FTP class was found. BMI, neck, hip and waist circumference was associated with the FTP scale. CONCLUSIONS: although the FTP was not directly associated with OSAS severity, there was also evidence that an FTP increase is associated with an increase in the considered anthropometric parameters, and FTP can be a clinical tool used in the assessment of risk for OSAS risk factors.

Enamel Analysis by 3D Scanning after Three Orthodontic Clean-Up Procedures: An In-Vitro Test of a New Piezoelectric Tool.

(1) Background: To assess the clinical safety and efficacy of a new piezoelectric instrument for orthodontic clean-up; (2) Methods: An in-vitro comparative study on 75 teeth extracted for orthodontic reasons compared the tested method (Treatment 1) with two other procedures: One step finisher and polisher (Inverted cone One gloss Shofu Dental, Kyoto, Japan) (Treatment 2) and twelve-fluted tungsten carbide bur (123-603-00, Dentaurum, Pforzheim, Germany) and Sof-Lex discs Pop-On XT Kit (3M ESPE) (Treatment 3), with n:25 samples in each group. Clinical safety (enamel volume loss) and effectiveness (residual adhesive volume) were assessed using the structured light 3D scanner Atos Compact Scan (GOM GmbH) together with the support of Atos Professional software. The surfaces were scanned three times to assess: (i) the volume of the residual adhesive (RAV) after bracket removal; (ii) the volume of the relative residual adhesive (dAV) after the clean-up procedure; (iii) volume of the enamel loss (EVL); (3) Results: The mean RAV (mm3) was 0.239 ± 0.337; 0.069 ± 0.124, 0.120 ± 0.193 and the mean EVL (mm3) was 0.1870 ± 0.177, 0.187 ± 0.299 and 0.290 ± 0.205, for treatment 1, 2 and 3, respectively. The distribution was asymmetrical between groups in both cases; (4) Conclusions: The tested instrument proved to be effective and safe for post-orthodontic clean-up. With the increasing use of invisible aligners, the possibility of using an ergonomic and fast instrument is of benefit to both patient and practitioner.

Del Nido versus cold blood cardioplegia in adult patients with impaired ejection fraction undergoing valvular and complex heart surgery.

BACKGROUND: There is sparse evidence on the efficacy of del Nido cardioplegia in high-risk patients with reduced ejection fraction undergoing valvular or complex heart surgery, and further investigation is required. METHODS: An institutional registry was searched for patients who underwent valvular or complex heart surgery and had an ejection fraction <40%. Subjects who received del Nido cardioplegia (DNC) and cold blood cardioplegia (CBC) were selected. Propensity matching was performed with age, gender, and number of conducted procedures as matching criteria. A comparative analysis was performed on primary endpoints of the troponin rise and changes in ejection fraction (EF). A composite endpoint of a troponin rise of ≥20× baseline or fall of EF≥5% was assessed in a multivariate analysis. Other perioperative complications are reported. RESULTS: One hundred patients from the DNC group were matched to the 100 patients in the CBC group. There were no differences between groups at baseline. Postoperatively, lower troponin values were observed in the DNC group at 12 hours (median; IQR: 523.2;349.1-740.4 pg/mL vs. 787.6;443.6-1689.0 pg/mL; P=0.016) and 36 hours (median; IQR: 426.1;337.2-492.1 pg/mL vs. 653.7;398.8-1737.5 pg/mL; P=0.044). Fewer patients in the DNC group had a fall in EF≥5% (7% vs. 16%; P=0.046). The multivariable analysis did not reveal a significant predictor of composite endpoint. CONCLUSIONS: In patients with impaired contractility undergoing valvular and complex procedures, the use of del Nido cardioplegia as an alternative to cold blood cardioplegia is associated with lower troponin release and improved preservation of ejection fraction.

Use of del Nido cardioplegia in acute coronary syndrome cases with decreased ejection fraction.

BACKGROUND: There has been increasing interest in using del Nido cardioplegia in adult cardiac surgery. However, there is limited evidence for its efficacy in patients with acute coronary syndrome and reduced ejection fraction. METHODS: This study examined patients with decreased ejection fraction (EF < 40%) who were hospitalized due to acute coronary syndrome and received either del Nido (DN) or cold blood cardioplegia (CB). The patients were matched based on age, gender, myocardial infarction at baseline, and number of conducted surgical procedures. An analysis was conducted on postoperative biomarker release (high-sensitivity troponin T and isoenzyme creatine kinase-MB (CK-MB)), changes in myocardial contractility and perioperative outcomes. RESULTS: 62 pairs of patients with similar baseline characteristics were selected. 51.6% of pairs underwent isolated coronary artery bypass grafting, while 48.4% underwent a complex procedure. Postoperative troponin values did not differ significantly at 12 h (median (IQR): 606.7 (381.4-974.8) pg/mL vs. 552 (231.8-1579.5) pg/mL; p = 0.913), nor did CK-MB (median (IQR): 24.3 (12.6-45.5) ng/mL vs. 23.7 (12.3-49.8) ng/mL; p = 0.972). The postoperative EF was similar between groups (median (IQR): 30% (30-35%) vs. 34% (30-38%); p = 0.323). No difference in perioperative mortality, myocardial infarction, stroke, or composite endpoint was noted. In a multivariate analysis, the cardioplegia protocol did not affect biomarker release or changes in ejection fraction. The first stage of acute kidney injury was more frequent in the CB group (28.5% vs. 9.7%, p = 0.033). CONCLUSIONS: Both del Nido and cold blood cardioplegia provide adequate cardioprotection in patients with acute coronary syndrome with decreased ejection fraction.

Influence of Primary Palatal Surgery on Craniofacial Morphology in Patients with Cleft Palate Only (CPO)-Systematic Review with Meta-Analysis.

BACKGROUND: Cleft palate only (CPO) is the second most prevalent cleft type. Both the cleft and palatal scarring may affect craniofacial growth. The aim of this systematic review was to summarize scientific evidence on effect of palatal surgery on craniofacial morphology in CPO. METHODS: A search was conducted in PubMed, PMC, WoS, Scopus, Embase, using the keywords: "cleft palate" AND ("craniofacial morphology" OR "cephalometric analysis") NOT "lip" with inclusion and exclusion criteria ensuring confident, direct comparison between study groups. The quality assessment was performed with Arrive's scale for radiologic examinations. RESULTS: Of 713 potential articles, 19 were subjected to qualitative analysis and 17 to meta-analysis, which confirmed reduced SNA in unoperated CPO versus non-cleft individuals. No scientific evidence was found directly assessing the effect of surgery on craniofacial morphology. The negative effect of palatal surgery was seen indirectly: in treated CPO versus non-cleft, the size effect of SNA is bigger than in untreated CPO versus non-cleft. A high heterogeneity came from a few non-European publications. CONCLUSIONS: CPO is associated with sagittal maxillary deficiency resulting both from the cleft and from primary surgery, disregarding cleft severity in operated CPO patients. Ethnic differences influence craniofacial morphology in CPO. This research received no external funding. Study protocol number in PROSPERO database: CRD42021268957.

Quality of Life and Stress Management in Healthcare Professionals of a Dental Care Setting at a Teaching Hospital in Rome: Results of a Randomized Controlled Clinical Trial.

In the healthcare environment, more and more people experience work-related stress. The Faculty of Medicine and Dentistry of Sapienza University of Rome, having observed the need to take care of healthcare professionals, has set itself the objective of providing useful tools such as additional and necessary personal protective equipment for healthcare professionals. OBJECTIVE: To promote health through better management, skills, and the use of strategies and solutions to identify, decompress, and neutralize those responsible for work-related stress mechanisms in order to take care of those who care (CURARE CURANTES). MATERIALS AND METHODS: A randomized controlled clinical trial was conducted. The participants were enrolled by three departments of the Department of Dental and Maxillofacial Sciences of Rome; in consideration of emotional involvement of health professionals who work there. A motivational program was offered. RESULTS: There were 17 and 16 healthcare professionals in the intervention and control groups, respectively. Levels of the mental composite score (MCS) varied both in the pre-post phase of the intervention group (p = 0.002), and between the intervention group and control group in the post phase (p = 0.006). No significant differences were observed for the physical composite score (PCS). Similarly, there were no significant differences regarding the positivity scale (PS) and the two dimensions of work-related stress (job demand and decision latitude). CONCLUSION: This study demonstrates the efficacy of yoga training practiced directly in the workplace and wearing work clothes, entering the work context, not weighing further on the healthcare workload, and being a way to carry out physical activity even in those cases in which professionals do not have the time to do it in their free time.