Efficacy of amniotic membrane with coronally advanced flap in the treatment of gingival recession: an updated systematic review and meta-analysis.

OBJECTIVES: This systematic review aims to evaluate the efficacy of combining the amniotic membrane (AM) with the coronally advanced flap (CAF) in the treatment of Miller class I and II gingival recession (GR). METHODS: The protocol of this updated PRISMA-compliant systematic review was registered in PROSPERO (CRD42023431501). The following treatment outcomes were recorded; recession depth (RD), recession width (RW), width of keratinized gingiva (WKG), and clinical attachment level (CAL). We searched the following databases: MEDLINE, Cochrane Library, Google Scholar, EMBASE, Web of Science, and Science Direct. RESULTS: Two independent reviewers screened the selected articles. Twenty-two eligible articles were extracted, with 689 sites of GR in 481 patients. No statistically significant difference was found in RD, RW, WKG, and CAL between (AM&CAF) in comparison to control groups. However, the subgroup analysis showed statistically significant differences in RD between the (AM & CAF) group v/s (CAF) alone (P = 0.004). Moreover, the subgroup analysis of the WKG showed statistically significant differences between (AM & CAF) v/s (CAF&CM) (p = 0.04). Additionally, a statistically significant difference was found in the subgroup analysis of CAL between both (AM & CAF) group v/s (CAF) alone (p = 0.0009). CONCLUSION: With the limitations of this meta-analysis due to short follow-up periods (6 months), the AM can be considered a viable treatment option for GR defects with satisfactory treatment outcomes comparable to other previously investigated treatment modalities. CLINICAL SIGNIFICANCE: While AM showed various beneficial properties as an ideal membrane for the coverage of GR, future studies are required to completely understand the potential application of AM in the treatment of GR.

Efficacy of buccal pad fat as a new approach in the treatment of gingival recession: a systematic review.

OBJECTIVE: This systematic review evaluates the efficacy of buccal pad fat (BPF) as an autologous graft in the treatment of gingival recession (GR). Thus, the research question explores if the BPF can serve as a viable alternative to the gold standard connective tissue graft. MATERIALS AND METHODS: Only seven studies met the inclusion criteria were critically appraised including the randomized controlled clinical trials, and case series. The inclusion criteria were systemically healthy individuals in the age range (18-65 years old) with Miller's classification of GR either class I, II, III, or IV while exclusion criteria were patients with poor oral hygiene, pregnant and lactating patients, teeth with caries, any prior surgery in the relevant regions, and use of medications. RESULTS: The review included 117 patients with 136 GR defects. The age of participants ranges from 20 to 65 years old with the higher percentage of root coverage (%RC) at 6 months in the pedicled BPF group which was 89.30%while the lowest (%RC) at 6 months in the same group was 46.78%. The BPF group's width of keratinized gingiva (WKG) values indicate a notable improvement, suggesting a positive impact on WKG compared to the control group. CONCLUSIONS: BPF can be considered as a promising graft to augment gingival tissues at different sites in the oral cavity with different Miller's classes of GR providing a new era in GR treatment.

The efficacy of diode laser and subgingival air polishing with erythritol in treatment of periodontitis (clinical and microbiological study).

BACKGROUND: There is insufficient clinical and microbiological evidence to support the use of diode laser and air-polishing with erythritol as supplements to scaling and root planning(SRP). The aim of the current study is to evaluate the clinical and microbiologic efficacy of erythritol subgingival air polishing and diode laser in treatment of periodontitis. METHODS: The study encompassed twenty-four individuals seeking periodontal therapy and diagnosed with stage I and stage II periodontitis. Eight patients simply underwent SRP. Eight more patients had SRP followed by erythritol subgingival air polishing, and eight patients had SRP followed by diode laser application. At baseline and six weeks, clinical periodontal parameters were measured, including Plaque Index (PI), Gingival Index (GI), periodontal Probing Depth (PPD), and Clinical Attachment Level (CAL). The bacterial count of Aggregatibacter actinomycetemcomitans(A.A), Porphyromonas gingivalis (P.G) was evaluated at different points of time. RESULTS: The microbiological assessment revealed significant differences in the count of A.A. between the laser and erythritol groups immediately after treatment, indicating a potential impact on microbial levels. However, the microbial levels showed fluctuations over the subsequent weeks, without statistically significant differences. Plaque indices significantly decreased post-treatment in all groups, with no significant inter-group differences. Gingival indices decreased, and the laser group showed lower values than erythritol and control groups. PPD and CAL decreased significantly across all groups, with the laser group exhibiting the lowest values. CONCLUSION: The supplementary use of diode laser and erythritol air polishing, alongside SRP, represents an expedited periodontal treatment modality. This approach leads to a reduction in bacteria and improvement in periodontal health. TRIAL REGISTRATION: This clinical trial was registered on Clinical Trials.gov (Registration ID: NCT06209554) and released on 08/01/2024.

A lower prevalence of malignant lymphoma in Sjögren's syndrome patients: A cross-sectional study.

OBJECTIVE: This study aims to determine the prevalence and risk factors associated with lymphoma in primary Sjögren's syndrome (pSS). METHODS: We conducted a cross-sectional study on pSS patients who were registered into the Integrated Data Repository (IDR) at the University of Florida (UF) Health Shands Hospital. The parameters, such as age, sex, race, and smoking status, were included. Lymphoma types in pSS were categorized. The clinical and laboratory features were compared between pSS patients with and those without lymphoma by utilizing the items in the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI). RESULTS: Among 1,211,343 patients, we found 6799 patients (0.56%) with lymphomas and 2562 patients (0.21%) with pSS. Out of the 2562 pSS patients, 67 patients (2.6%) were diagnosed with lymphoma. The difference in the clinical and laboratory features listed under the ESSDAI domains between pSS patients with lymphomas and pSS without it was significant (p < 0.05 or 0.01): fever, weight loss, lymphadenopathy, splenomegaly, lacrimal gland diseases, cough, shortness of breath, hematuria, cerebrovascular accident diseases, peripheral nerve involvement due to vasculitis, neutropenia, and thrombocytopenia. CONCLUSION: We report 2.6% of lymphoma prevalence in pSS, lower than previously reported in the literature.

Lichen planus after COVID-19 infection and vaccination.

BACKGROUND: Lichen planus is one of the common adverse reactions after COVID-19 infection and vaccination. Despite it being reported in several case reports, the literature including a large sample of the studied population is lacking. The current study was performed to assess the risk of LP after COVID-19 infection as well as COVID-19 vaccination. METHODS: The current study was designed as a retrospective cross-sectional hospital-based study of registered patients at the University of Florida (UF) health centers. The diagnoses of LP, COVID-19 infection, and COVID-19 vaccines were detected. The logistic regression model was used to assess the risk of developing LP after COVID-19 infection and vaccination. RESULTS: A total hospital patient of 684,110 attended UF Health centers were included in this study. 181 patients reported LP after COVID-19 vaccination and 24 patients developed LP after COVID-19 infection. The risk of developing LP after COVID-19 vaccination was 1.573 while the risk of developing LP after COVID-19 infection was 1.143. CONCLUSION: The odds of getting LP after COVID-19 vaccination are significantly developed. The current study showed that COVID-19 infection and vaccination are associated with LP. So, healthcare practitioners should be aware of this reaction for rapid recognition and treatment.

Localization and characterization of human papillomavirus-16 in oral squamous cell carcinoma.

OBJECTIVES: The role of Human papillomavirus (HPV) in the oral squamous cell carcinoma (OSCC) has not been completely elucidated. The purpose of the present study was to investigate the prevalence and localization of HPV-16 virus in OSCC and to correlate HPV-16 positivity and p16INK4A expression with the clinical and pathological features of OSCC. METHODS: The archives of Oral Pathology at the University of Florida, College of Dentistry were accessed for demographic, clinical, histopathological data, and slides of 114 OSCC patients. HPV-16 positivity of OSCC was evaluated by p16INK4A immunohistochemistry (IHC) and HPV-16 E6/E7mRNA by in situ hybridization (ISH). RESULTS: Out of 114 consecutive pathological slides of OSCC, 16 samples (14%) showed positivity for p16INK4A by IHC and 14 samples (12%) were positive for HPV-16 E6/E7mRNA ISH and the Positivity showed a significant correlation with the patients' age, alcohol consumption, and the degree of OSSC differentiation. The hard palate showed the highest positivity of p16INK4A IHC and HPV-16 mRNA ISH (38%, 36% respectively). CONCLUSION: HPV-16 is a significant factor in oral carcinogenesis. We recommend using p16INK4A as a surrogate marker for HPV detection in OSCC, which can be complemented by RNA ISH for the identification of HPV subtypes.

Walking against traffic and pedestrian injuries in the United Kingdom: new insights.

BACKGROUND: Studies from Finland and Taiwan have shown that walking against traffic was beneficial for reducing pedestrian crashes and fatalities. This study examined whether such beneficial effects are consistent across various circumstances. METHODS: This study aimed to investigate pedestrian fatalities in walking-against or with-traffic crashes by analysing the UK STATS19 crash data for the period between 1991 and 2020. We firstly employed Chi-square tests to examine risk factors for pedestrian injury severity. These variables were then incorporated into stepwise logistic regression models with multiple variables. We subsequently conducted joint effect analysis to investigate whether the beneficial effects of walking against traffic on injury severity vary across different situations. RESULTS: Our data contained 44,488 pedestrian crashes, of which 16,889 and 27,599 involved pedestrians walking against and with traffic, respectively. Pedestrians involved in with-traffic crashes were more likely to sustain fatalities (adjusted odds ratio [AOR] = 1.542; confidence interval [CI] = 1.139-1.927) compared with those in walking against-traffic crashes. The detrimental effect of walking with traffic on fatalities appeared to be more pronounced in darkness-unlit conditions (AOR = 1.48; CI = 1.29-1.70), during midnight hours (00:00-06:59 am) (AOR = 1.60; CI = 1.37-1.87), in rural areas (AOR = 2.20; CI = 1.92-2.51), when pedestrians were elderly (≥ 65 years old) (AOR = 2.65, CI = 2.16-3.26), and when heavy goods vehicles were crash partners (AOR = 1.51, CI = 1.28-1.78). CONCLUSIONS: Walking against traffic was beneficial in reducing pedestrian fatalities compared with walking with traffic. Furthermore, such a beneficial effect was more pronounced in darkness-unlit conditions, at midnights (00:00-06:59 am), in rural areas, when pedestrians were elderly, and when heavy goods vehicles struck pedestrians.

Evaluating the effect of drunk driving on fatal injuries among vulnerable road users in Taiwan: a population-based study.

BACKGROUND: Most studies have focused on injuries sustained by intoxicated drivers themselves, but few have examined the effect of drunk driving on injury outcomes among VRUs (vulnerable road users) in developing countries. This study aims to evaluate the effect of drunk driving on fatal injuries among VRUs (pedestrians, cyclists, or motorcyclists). METHODS: The data were extracted from the National Taiwan Traffic Crash Dataset from January 1, 2011, to December 31, 2019. Crashes involving one motorized vehicle and one VRU were considered. This study examines the effect of drunk driving by estimating multivariate logistic regression models of fatal injuries among VRUs after controlling for other variables. RESULTS: Among 1,416,168 casualties, the fatality rate of VRUs involved in drunk driving was higher than that of general road users (2.1% vs. 0.6%). Drunk driving was a significant risk factor for fatal injuries among VRUs. Other risk factors for fatal injuries among VRUs included VRU age ≥ 65 years (adjusted odds ratio [AOR]: 5.24, 95% confidence interval [CI]: 5.53-6.07), a nighttime accident (AOR: 4.52, 95% CI: 4.22-4.84), and being hit by a heavy-duty vehicle (AOR: 2.83, 95% CI: 2.26-3.55). Subgroup analyses revealed a linear relationship between driver blood alcohol concentration (BAC) and the risk of fatal injury among motorcyclists. Motorcyclists exhibited the highest fatality rate when they had a BAC ≤ 0.03% (AOR: 3.54, 95% CI: 3.08-4.08). CONCLUSION: Drunk driving was associated with a higher risk of fatality for all VRUs. The risk of fatal injury among motorcyclists was linearly related to the BAC of the drunk drivers. Injuries were more severe for intoxicated motorcyclists, even those with BAC ≤ 0.03%, which is within the legal limit.

Assessing the Impacts of Autonomous Vehicles on Road Congestion Using Microsimulation.

The introduction of autonomous vehicles has been considered as a possible option for reducing traffic congestion in many transport studies. Many types of models, in particular car-following microsimulation models have been adopted in most studies. The impacts of autonomous vehicles (AVs) on congestion, however, have not yet been concluded. This could be because different researchers use different forms of car-following models to assess these impacts, or because the utilised modelling approaches and their parameters are different in different studies. In particular, two of the important parameters that are associated with car-following models are the used values for maximum acceleration and the average desired time gaps. While the values of these parameters can be adjusted and controlled by the ACC controllers in the AV, they can also be controlled by the users. Therefore, assigning unrealistic values to these parameters could well result in unrealistic conclusions. This paper investigated the impacts of the maximum acceleration and the average desired time gaps on congestion levels using the loss-time indicator. The analysis was carried out on the Hanshin expressway in Japan and was tested and assessed using the Helly (FACC) car-following microsimulation model. This includes estimating the values of the desired time gap from real traffic time-gap distributions. The Hanshin expressway is an urban toll highway of 273 km that extends from Osaka to Kobe, representing the Hanshin area in Japan. The Hanshin highway serves a huge traffic volume that consists of private and freight vehicles that operate within the Hanshin area. This area represents one of three major municipal areas in Japan including Tokyo and Nagoya. A total of 740,000 vehicles per day travel on the expressway. As a result, there is significant congestion on the Hanshin expressway. There have been various plans put in place to ease congestion ranging from building new roads to the implementation of traffic-demand-management measures. However, the predictions of the impacts of such measures do not provide any evidence that they would ease traffic congestion. Other possible measures that could be investigated for easing traffic congestion include technology-based solutions such as autonomous vehicles. The modelling results recommend that the results obtained from microsimulation models should be taken with care, and good attention should be paid to the parameters used and their values in the model. The values assigned to driving-behaviour parameters, the maximum values of acceleration, and the time-gap settings, for example, control the final outcomes of the models.

Clinical usefulness of anti-muscarinic type 3 receptor autoantibodies in patients with primary Sjögren's syndrome.

OBJECTIVES: To elucidate the clinical values of anti-M3R in Sjögren's syndrome (SS) in the largest cohort for an anti-M3R study. METHODS: The plasma of 361 subjects (156 primary SS [pSS], 62 non-SS-sicca [SICCA], 40 systemic lupus erythematosus [SLE], 50 rheumatoid arthritis [RA], and 53 healthy controls [HC]) was screened using our modified On-Cell-Western assay. Saliva from pSS (n=37) compared to SICCA (n=26) was also analysed. The sensitivity and specificity of anti-M3R and its association with comprehensive clinical and laboratory features were determined. RESULTS: Plasma-anti-M3R was higher in pSS compared to other groups, differentiating pSS with good-to-excellent diagnostic power with a specificity of 85% and a sensitivity between 75% and 98%. pSS plasma-anti-M3R was positively correlated with ocular staining scores, anti-Ro/SSA, IgG, ß2-microglobulin, ESR, and ESSDAI. It was negatively correlated with WBC, C4, and salivary scintigraphic indices. Saliva-anti-M3R was 3.59 times higher in pSS than in SICCA. Interestingly, the agreement between the 2002 American European Consensus Group criteria and the criteria substituted with plasma-anti-M3R for the lip biopsy reached 92%, with a significant kappa of 0.824. CONCLUSIONS: Anti-M3R enhances sensitivity and specificity for SS diagnosis, correlating with ocular dryness and glandular hypofunction, and the haematological/biological domains of the ESSDAI. Our findings also highlight the clinical significance of anti-M3R in SS diagnosis, especially where clinical assessments, such as lip biopsy, sialometry, or ocular evaluation, by multi-disciplinary specialists are limited.

An Investigation into the Appropriateness of Car-Following Models in Assessing Autonomous Vehicles.

The dramatic progress of Intelligent Transportation Systems (ITS) has made autodriving technology extensively emphasised. Various models have been developed for the aim of modelling the behaviour of autonomous vehicles and their impacts on traffic, although there is still a lot to be researched about the technology. There are three main features that need to be represented in any car-following model to enable it to model autonomous vehicles: desired time gap, collision avoidance system and sensor detection range. Most available car-following models satisfy the first feature, most of the available car-following models do not satisfy the second feature and only few models satisfy the third feature. Therefore, conclusions from such models must be taken cautiously. Any of these models could be considered for updating to include a collision avoidance-system module, in order to be able to model autonomous vehicles. The Helly model is car-following model that has a simple structure and is sometimes used as the controller for Autonomous Vehicles (AV), but it does not have a collision avoidance concept. In this paper, the Helly model, which is a very commonly used classic car-following model is assessed and examined for possible update for the purpose of using it to model autonomous vehicles more efficiently. This involves assessing the parameters of the model and investigating the possible update of the model to include a collision avoidance-system module. There are two procedures that have been investigated in this paper to assess the Helly model to allow for a more realistic modelling of autonomous vehicles. The first technique is to investigate and assess the values of the parameters of the model. The second procedure is to modify the formula of that model to include a collision avoidance system. The results show that the performance of the modified full-range Auto Cruising Control (FACC) Helly model is superior to the other models in almost all situations and for almost all time-gap settings. Only the Alexandros E. Papacharalampous's Model (A.E.P.) controller seems to perform slightly better than the (FACC) Helly model. Therefore, it is reasonable to suggest that the (FACC) Helly model be recommended as the most accurate model to use to represent autonomous vehicles in microsimulations, and that it should be further investigated.

Effect of motorcycle helmet types on head injuries: evidence from eight level-I trauma centres in Taiwan.

BACKGROUND: Motorcycle full-coverage helmet use may reduce fatalities and head injuries. METHODS: This retrospective cohort study extracted injury data from eight level-I trauma centres in Taiwan and performed a questionnaire survey to investigate injuries sustained by motorcyclists for the period between January 2015 and June 2017. RESULTS: As many as 725 patients participated in the questionnaire survey and reported their helmet types or phone use during crashes. The results of multivariate logistic models demonstrated that nonstandard helmet (half or open-face helmet) use was associated with an increased risk of head injuries and more severe injuries (injury severity score ≥ 8). Drunk riding and phone use appeared to be two important risk factors for head injuries and increased injury severity. Anaemia was also found to be a determinant of head injuries." CONCLUSIONS: Compared to full-coverage helmets, nonstandard provide less protection against head injuries and increased injury severity among motorcyclists.

Secretome Analysis of Inductive Signals for BM-MSC Transdifferentiation into Salivary Gland Progenitors.

Severe dry mouth in patients with Sjögren's Syndrome, or radiation therapy for patients with head and neck cancer, significantly compromises their oral health and quality of life. The current clinical management of xerostomia is limited to palliative care as there are no clinically-proven treatments available. Previously, our studies demonstrated that mouse bone marrow-derived mesenchymal stem cells (mMSCs) can differentiate into salivary progenitors when co-cultured with primary salivary epithelial cells. Transcription factors that were upregulated in co-cultured mMSCs were identified concomitantly with morphological changes and the expression of acinar cell markers, such as α-amylase (AMY1), muscarinic-type-3-receptor(M3R), aquaporin-5(AQP5), and a ductal cell marker known as cytokeratin 19(CK19). In the present study, we further explored inductive molecules in the conditioned media that led to mMSC reprogramming by high-throughput liquid chromatography with tandem mass spectrometry and systems biology. Our approach identified ten differentially expressed proteins based on their putative roles in salivary gland embryogenesis and development. Additionally, systems biology analysis revealed six candidate proteins, namely insulin-like growth factor binding protein-7 (IGFBP7), cysteine-rich, angiogenetic inducer, 61(CYR61), agrin(AGRN), laminin, beta 2 (LAMB2), follistatin-like 1(FSTL1), and fibronectin 1(FN1), for their potential contribution to mMSC transdifferentiation during co-culture. To our knowledge, our study is the first in the field to identify soluble inductive molecules that drive mMSC into salivary progenitors, which crosses lineage boundaries.

Increased prevalence of erythema multiforme in patients with COVID-19 infection or vaccination.

Several reports stated that erythema multiforme (EM) was associated with COVID-19 with detrimental outcomes in patients. However, since most of these are case reports, it is challenging to quantitively assess their associations. Therefore, our study aims to determine the prevalence of EM in the context of COVID-19. The study was designed as a retrospective cross-sectional hospital-based study of registered patients at the University of Florida Health Hospital. The ICD-10 codes for EM, COVID-19 infection, and COVID-19 vaccines were searched in the database. The odds ratio was calculated to assess the risk of EM after COVID-19 infection or vaccination. Our study included 43,547 patients with a history of COVID-19 infection, of whom 92 developed EM. Patients with COVID-19 infection were 6.68 times more likely to have EM than those without COVID-19 (P < 0.0001). Similarly, the risk of developing EM after COVID-19 vaccination was 2.7, significantly higher than the general population (P < 0.0001). The prevalence of EM following COVID-19 infection or vaccination significantly differs from the general population, highlighting the importance of monitoring patients for EM after COVID-19 infection and/or vaccination. It is imperative to disseminate awareness to clinicians and patients regarding the impact of COVID-19 on EM.

Association between tonsillectomy and oropharyngeal cancer risk: a retrospective cohort study.

BACKGROUND: The purpose of this retrospective cohort study is to describe the association between the history of tonsillectomy and the risk of oropharyngeal squamous cell carcinoma (OPSSC), using a large cohort of patients. MATERIALS AND METHODS: We performed a retrospective cohort study with 3620 patients diagnosed with OPٍSCC from 2010 to 2021. We utilized the University of Florida patients' registry i2b2 system. Three subsets of OPSSC were defined, base of tongue(BOT) cancer, tonsillar cancer, and other OPSSC. Tumor demographics and history of tonsillectomy were collected. Odds ratio for OPSSC were assessed utilizing a logistic regression model with adjusting for gender, race, and age. P < 0.05 was deemed significant. RESULTS: Of the 3620 OPSSC patients were BOT cancer (N = 964), tonsillar cancer (N = 995), and other OPSSC (N = 1661). There was a statistically significant reduction in tonsillar cancer and BOT cancer odds ratio in patients with a history of tonsillectomy vs. patients without tonsillectomy (0.086 and 0.117), respectively, with a P value < .0001. The odds ratio of OPSSC in patients with a history of tonsillectomy vs. patients without tonsillectomy is 1.031. CONCLUSION: This study showed that the OPSSC and previous history of tonsillectomy are associated. Our results showed a significant reduction in BOT and tonsillar cancer risk in patients with a history of tonsillectomy and an insignificant decrease in other OPSSC. This study could emphasize the importance of the development of future clinical trials to investigate the role of prophylactic tonsillectomy as a secondary preventive strategy to reduce OPSSC.

A rare presentation of a mucocele in a separate compartment of maxillary sinus.

Maxillary sinus is frequently presented as a single space within each maxilla. It drains directly into the nose through the middle meatus. We are reporting the second rare case of a mucocele in a separate compartment of maxillary sinus in a 26-year-old patient without a history of facial trauma. The non-contrast computed tomography of paranasal sinuses showed an expansile right infraorbital cystic lesion developed in an upper lateral position of the maxillary sinus. An excision biopsy was performed, which showed histopathological findings of a maxillary sinus mucocele.

Unhelmeted Riding, Drunk Riding, and Unlicensed Riding among Motorcyclists: A Population Study in Taiwan during 2011-2016.

This study aimed to investigate the association between drunk riding, unhelmeted riding, unlicensed riding, and running-off-road (ROR) crashes. Multiple logistic regression was used to calculate the adjusted odds ratio (AOR) by using the National Taiwan Traffic Crash Dataset for 2011-2016. The results revealed that unhelmeted riding was associated with 138% (AOR = 2.38; CI (confidence interval) = 2.34-2.42) and 47% (AOR = 1.47; CI = 1.45-1.49) higher risks of drunk riding and unlicensed riding, respectively. The risk of unhelmeted riding increased with blood alcohol concentrations (BACs), and riders with the minimum BAC (0.031-0.05%) had nearly five times (AOR = 4.99; CI = 4.74-5.26) higher odds of unlicensed riding compared with those of riders with a negative BAC. Unhelmeted riding, drunk riding, and unlicensed riding were associated with 1.21 times (AOR = 1.21; CI = 1.13-1.30), 2.38 times (AOR = 2.38; CI = 2.20-2.57), and 1.13 times (AOR = 1.13; CI = 1.06-1.21) higher odds of ROR crashes, respectively. The three risky riding behaviours (i.e., unhelmeted riding, drunk riding, and unlicensed riding) were significantly related to ROR crashes. The risk of unhelmeted riding and ROR crashes increased with BACs.

Clinical responses of patients with systemic diseases to the photodynamic therapy of oral lichen planus.

BACKGROUND: Oral lichen planus (OLP) is a chronic disease commonly detected in older aged patients with female predominance. Treatment of OLP in diabetic and hypertensive patients usually shows some difficulties which require a more safe and effective treatment modality such as Photodynamic therapy (PDT). The current study aims to evaluate the role of PDT in treating OLP in diabetic and hypertensive patients. METHODS: We evaluated the role of PDT in treating erosive OLP of type 2 diabetic and hypertensive patients. The following parameters were evaluated for each case at the time zero, after2 weeks, and 4 weeks of the study: subjective responses, objective responses, and the size of the lesion. RESULTS: Our study included 9 diabetic and 7hypertensive patients with an age range of 30:60 years old. There were statistically significant differences between the diabetic and hypertensive patients in the objective response, area of ulceration, and the area of erythema at the end of the 4th week of the study (p<0.05). CONCLUSION: PDT is an effective treatment modality for diabetic and hypertensive patients with no side effects or patient discomfort.

Multiple oral squamous cell carcinoma 6 years after allogeneic stem cell transplantation complicated with chronic graft-versus-host disease: A case report.

Oral squamous cell carcinoma is a potential long-term complication after hematopoietic stem cell transplantation. This may be related to mechanisms including radiation and chemotherapy regimens, chronic graft-versus-host disease, inflammation, and prolonged immunosuppression. The current case describes the development of multiple oral white thick keratotic lesions in the floor of the mouth and the tongue 6 years after hematopoietic stem cell transplantation complicated with chronic graft-versus-host disease. A biopsy performed with histopathological analysis revealed a well-differentiated squamous cell carcinoma. The patient was treated by subtotal glossectomy, bilateral neck dissection, and flap reconstruction. This report highlights the significance of the routine oral examination of long-term surveillance post hematopoietic stem cell transplantation to ensure early detection of these tumors at potentially treatable stage.

Health Research Priority Agenda for Ministry of Health, Kingdom of Saudi Arabia from 2020 to 2025.

METHOD: The current study applied e-Delphi technique via online self-administered questionnaire was distributing to headquarter, and 16 health affairs directorates spanning 75 hospitals and specialized health centers, 24 primary health-care centers, 2 health-care clusters, and 5 medical cities. In addition, community involvement was represented by 26 organizations: 7 universities, 9 scientific health associations, 5 charitable associations, and 5 key Saudi health partner organizations. Research field's prioritization was performed by ranking weighed mean aggregate score via application of the combined consensus and metrics-based approach. Then the top five research topics were analyzed, verified, refined and classified into specific health research themes. RESULTS: The study included 2252 participants and attained a 90% response rate. The study deliverables were listed into two research priority domains: health system research priorities (1st agenda) and diseases and health problems priorities (2nd agenda). Overall, the types of the top five research priorities in the first agenda included service delivery (40.9%), health workforce (14.4%), governance and leadership (13.0%) ,preparedness and response to disasters and emergency (10.2%), health information systems (9.3%), access to essential medicines products and vaccines (6.97%), and financing (5.1%). On the other hand, the top five research priority areas in the second agenda were non-communicable diseases (16.9%), child and neonatal health (15.9%), medications (13.6%), women health (10.4%), dental health (10.4%). furthermore, biomedical and radiology technology and devices (5.6%), communicable diseases (3.7%), nutrition (3.2%), trauma and general management (3.2%), innovative approaches (2.4%), emergency management (2.7%), physical therapy and rehabilitation (2.3%), public health (2.3%), holistic approaches to health and wellness, behavior and lifestyle (1.5%), environmental health (0.6%),pilgrims' health (0.6%), geriatric health (0.3%), and family medicine (0.3%). CONCLUSION: Adequate description of the stakeholders and methodology can strengthen legitimacy and credibility and maximize the impact of the priority-setting process. Involvement of policymakers, researchers and funding organizations increases the opportunity of translation into actual research, supports redesigning the research landscape and ensures uptake of results and integration.