scholarly journals Diagnostic and treatment algorithm for different phenotypes of chronic rhinosinusitis with nasal polyps

2019 ◽  
Vol 16 (2) ◽  
pp. 50-60 ◽  
Author(s):  
E L Savlevich ◽  
M E Dyneva ◽  
L E Gaganov ◽  
V I Egorov ◽  
A N Gerasimov ◽  
...  
Keyword(s):  
Allergic Asthma ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Treatment Algorithm ◽  
Clinical Manifestations ◽  
Diagnostic Biomarkers ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Asthma Group

Chronic rhinosinusitis with nasal polyps (CRSwNP) may vary in clinical manifestations and can often be associated with a number of comorbid diseases. For a practitioner it is important to forecast the development of the disease, evaluate the risk of relapse and select the most efficient method of treatment in each clinical case. At present, there are no standardized and validated diagnostic biomarkers that could be used as predictors of CRSwNP clinical course. Purpose of the study: to develop diagnostic and treatment algorithm for varies CRSwNP phenotypes based on clinical and laboratory parameters. Materials and methods, CRSwNP patients were split into 3 groups: group 1 - CRSwNP without allergy and asthma; group 2 - CRSwNP with allergic rhinitis and/or allergic asthma; group 3 - CRSwNP with non-allergic asthma. All patients were subjected to nasal cavity endoscopy and nasal polyps biopsy, allergological examination, histological analysis of polyp stroma to detect the leukocytes infiltration and eosinophil-neutrophil index (ENI). Results, CRSwNP phenotypes show significant difference in clinical manifestations of rhinosinusitis (p

ЛЕЧЕБНО-ДИАГНОСТИЧЕСКИЙ АЛГОРИТМ ПРИ РАЗНЫХ ФЕНОТИПАХ ПОЛИПОЗНОГО РИНОСИНУСИТА

2019 ◽  
Author(s):  
E.L. Savlevich ◽  
M.E. Dyneva ◽  
L.E. Gaganov ◽  
V.I. Egorov ◽  
A.N. Gerasimov ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Inflammatory Response ◽  
Allergic Asthma ◽  
Nasal Polyps ◽  
Mutual Influence ◽  
Treatment Algorithm ◽  
Clinical Manifestations ◽  
Local Inflammatory Response ◽  
Significant Difference ◽  
Asthma Group

Обоснование, Хронический полипозный риносинусит (ПРС) отличается широкой вариабельностью клинических проявлений. Для практического врача важно прогнозировать развитие заболевания, оценить риск рецидива и подобрать наиболее эффективный способ лечения в каждом конкретном случае. В настоящий момент отсутствуют стандартизированные, валидизированные диагностические биомаркеры, которые можно использовать в качестве предикторов клинического течения ПРС. Цель, Разработать алгоритм диагностики и лечения разных фенотипов ПРС на основе клинических и лабораторных показателей. Материалы и методы, Пациенты с ПРС были разделены на 3 группы: 1-я группа - ПРС без аллергии и бронхиальной астмы (БА), 2-я группа - ПРС в сочетании с аллергическим ринитом (АР) и/или аллергической БА (аБА), 3-я группа - ПРС в сочетании с неаллергической БА (нБА). Всем пациентам проводилась эндоскопия полости носа и взятие биопсии ткани носовых полипов, аллергологическое обследование, гистологическое исследование стромы полипов с определением степени выраженности лейкоцитарной инфильтрации и эозинофильно-нейтрофильного индекса. Результаты, Фенотипы ПРС достоверно различаются между собой по выраженности клинических проявлений риносинусита (р0,005), уровню эозинофилов крови (р0,001) и степени лейкоцитарной инфильтрации стромы полипов (р0,004). При этом при сочетании ПРС с АР, аБА и нБА отмечался более выраженный воспалительный ответ, что подтверждает факт взаимного влияния этих патологических процессов друг на друга. Также установлено, что абсолютное содержание эозинофилов в периферической крови не коррелирует с выраженностью эозинофильно-клеточной инфильтрации стромы носовых полипов, а следовательно, не несет клинически значимой информации об интенсивности локального воспалительного процесса в отличие от доказанной ранее взаимосвязи уровня эозинофилов в крови и в мокроте у больных БА. Заключение, Показана целесообразность фенотипирования ПРС в зависимости от сопутствующей патологии, что является необходимым инструментом при подборе терапии в каждом конкретном случае. Поэтому для улучшения контроля и предупреждения рецидива ПРС предложен лечебно-диагностический алгоритм ведения пациентов в зависимости от фенотипа заболеванияChronic rhinosinusitis with nasal polyps (CRSwNP) may vary in clinical manifestations and can often be associated with a number of comorbid diseases. For a practitioner it is important to forecast the development of the disease, evaluate the risk of relapse and select the most efficient method of treatment in each clinical case. At present, there are no standardized and validated diagnostic biomarkers that could be used as predictors of CRSwNP clinical course. Purpose of the study: to develop diagnostic and treatment algorithm for varies CRSwNP phenotypes based on clinical and laboratory parameters. Materials and methods, CRSwNP patients were split into 3 groups: group 1 - CRSwNP without allergy and asthma group 2 - CRSwNP with allergic rhinitis and/or allergic asthma group 3 - CRSwNP with non-allergic asthma. All patients were subjected to nasal cavity endoscopy and nasal polyps biopsy, allergological examination, histological analysis of polyp stroma to detect the leukocytes infiltration and eosinophil-neutrophil index (ENI). Results, CRSwNP phenotypes show significant difference in clinical manifestations of rhinosinusitis (p0.005), eosinophil blood count (p0.001), and polyps stroma leukocytes infiltration (p0.004). At the same time, the combination of CRSwNP with allergic rhinitis, allergic and non-allergic asthma showed a more pronounced inflammatory response, which once again confirms the fact of the mutual influence of these pathological processes on each other. It was also found that the absolute eosinophil blood in peripheral blood does not correlate with the severity of eosinophilic cell infiltration degree in nasal polyps stroma, and, consequently, does not have correlate clinically relevant information on intensity of the local inflammatory response, contrary to previously proven relation between eosinophil count in blood and sputum in patients with asthma. Conclusion, Our study showed the feasibility of phenotyping CRSwNP depending on the comorbidity, which is a necessary tool in the selection of therapy in each case. Therefore, to improve the control and prevention of relapse of CRSwNP, a diagnostic and treatment algorithm for the management of patients depending on the phenotype of the disease is proposed.

ЛЕЧЕБНО-ДИАГНОСТИЧЕСКИЙ АЛГОРИТМ ПРИ РАЗНЫХ ФЕНОТИПАХ ПОЛИПОЗНОГО РИНОСИНУСИТА

2019 ◽  
pp. 50-60
Author(s):  
E.L. Savlevich ◽  
M.E. Dyneva ◽  
L.E. Gaganov ◽  
V.I. Egorov ◽  
A.N. Gerasimov ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Inflammatory Response ◽  
Nasal Polyps ◽  
Mutual Influence ◽  
Treatment Algorithm ◽  
Clinical Manifestations ◽  
Relevant Information ◽  
Local Inflammatory Response ◽  
Significant Difference ◽  
Asthma Group

Обоснование, Хронический полипозный риносинусит (ПРС) отличается широкой вариабельностью клинических проявлений. Для практического врача важно прогнозировать развитие заболевания, оценить риск рецидива и подобрать наиболее эффективный способ лечения в каждом конкретном случае. В настоящий момент отсутствуют стандартизированные, валидизированные диагностические биомаркеры, которые можно использовать в качестве предикторов клинического течения ПРС. Цель, Разработать алгоритм диагностики и лечения разных фенотипов ПРС на основе клинических и лабораторных показателей. Материалы и методы, Пациенты с ПРС были разделены на 3 группы: 1я группа ПРС без аллергии и бронхиальной астмы (БА), 2я группа ПРС в сочетании с аллергическим ринитом (АР) и/или аллергической БА (аБА), 3я группа ПРС в сочетании с неаллергической БА (нБА). Всем пациентам проводилась эндоскопия полости носа и взятие биопсии ткани носовых полипов, аллергологическое обследование, гистологическое исследование стромы полипов с определением степени выраженности лейкоцитарной инфильтрации и эозинофильнонейтрофильного индекса. Результаты, Фенотипы ПРС достоверно различаются между собой по выраженности клинических проявлений риносинусита (р0,005), уровню эозинофилов крови (р0,001) и степени лейкоцитарной инфильтрации стромы полипов (р0,004). При этом при сочетании ПРС с АР, аБА и нБА отмечался более выраженный воспалительный ответ, что подтверждает факт взаимного влияния этих патологических процессов друг на друга. Также установлено, что абсолютное содержание эозинофилов в периферической крови не коррелирует с выраженностью эозинофильноклеточной инфильтрации стромы носовых полипов, а следовательно, не несет клинически значимой информации об интенсивности локального воспалительного процесса в отличие от доказанной ранее взаимосвязи уровня эозинофилов в крови и в мокроте у больных БА. Заключение, Показана целесообразность фенотипирования ПРС в зависимости от сопутствующей патологии, что является необходимым инструментом при подборе терапии в каждом конкретном случае. Поэтому для улучшения контроля и предупреждения рецидива ПРС предложен лечебнодиагностический алгоритм ведения пациентов в зависимости от фенотипа заболеванияChronic rhinosinusitis with nasal polyps (CRSwNP) may vary in clinical manifestations and can often be associated with a number of comorbid diseases. For a practitioner it is important to forecast the development of the disease, evaluate the risk of relapse and select the most efficient method of treatment in each clinical case. At present, there are no standardized and validated diagnostic biomarkers that could be used as predictors of CRSwNP clinical course. Purpose of the study: to develop diagnostic and treatment algorithm for varies CRSwNP phenotypes based on clinical and laboratory parameters. Materials and methods, CRSwNP patients were split into 3 groups: group 1 CRSwNP without allergy and asthma group 2 CRSwNP with allergic rhinitis and/or allergic asthma group 3 CRSwNP with nonallergic asthma. All patients were subjected to nasal cavity endoscopy and nasal polyps biopsy, allergological examination, histological analysis of polyp stroma to detect the leukocytes infiltration and eosinophilneutrophil index (ENI). Results, CRSwNP phenotypes show significant difference in clinical manifestations of rhinosinusitis (p0.005), eosinophil blood count (p0.001), and polyps stroma leukocytes infiltration (p0.004). At the same time, the combination of CRSwNP with allergic rhinitis, allergic and nonallergic asthma showed a more pronounced inflammatory response, which once again confirms the fact of the mutual influence of these pathological processes on each other. It was also found that the absolute eosinophil blood in peripheral blood does not correlate with the severity of eosinophilic cell infiltration degree in nasal polyps stroma, and, consequently, does not have correlate clinically relevant information on intensity of the local inflammatory response, contrary to previously proven relation between eosinophil count in blood and sputum in patients with asthma. Conclusion, Our study showed the feasibility of phenotyping CRSwNP depending on the comorbidity, which is a necessary tool in the selection of therapy in each case. Therefore, to improve the control and prevention of relapse of CRSwNP, a diagnostic and treatment algorithm for the management of patients depending on the phenotype of the disease is proposed.

scholarly journals Pathomorphological Features of the Mucoperiostasis of the Processus Uncinatus in Discrete Diseases of the Maxillary Sinus

2021 ◽  
Vol 6 (5) ◽  
pp. 255-262
Author(s):  
Ya. V. Shkorbotun ◽  
◽  
O. G. Kuryk ◽  
◽  
Keyword(s):  
Maxillary Sinus ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Sinus Surgery ◽  
Histological Features ◽  
Dental Implantation ◽  
Ostiomeatal Complex ◽  
History Of ◽  
Group 3 ◽  
Group 2

The state of the mucoperiostasis of the maxillary sinus is one of the important factors that affect the effectiveness of dental implantation, especially in case of need for augmentation of the maxillary bone. Chronic rhinosinusitis with nasal polyps, chronic rhinosinusitis with fungal bodies, and sinus cysts are among the most common pathological processes in the maxillary sinus that are encountered when performing subantral augmentation. In addition, a separate category of patients is made up of those with a history of sinus surgery in their anamnesis. The condition of sinus mucoperiosteum can be estimated based on results of processus uncinatus research, because it has a similar histological structure, directly contacts with all maxillary sinus excretion and, as usual, gets removed while endoscopic sinusotomy. The purpose of the work was to study the histological features of mucoperiostasis and adjacent bone in the ostiomeatal complex in discrete diseases of paranasal sinuses: chronic rhinosinusitis with nasal polyps, maxillary sinus cysts, fungal balls and postoperative scar changes in the ostium. Materials and methods. Histological features of processus uncinatus fragments removed during endoscopic interventions in 45 patients were investigated: with sinus cysts – 12 patients (group 1), chronic rhinosinusitis with nasal polyps – 13 patients (group 2), sinus fungal body – 13 patients (group 3) and postoperative scarring changes in the ostiomeatal complex – 7 patients. The condition of the epithelial layer of the mucoperiosteum, the structure of its own plate, the periosteal layer and the bone to be treated were evaluated. Results and discussion. In 91.67 ± 0.08% of patients with maxillary sinus cysts, there were no changes in the mucoperiostasis and the bone of processus uncinatus. Most patients in groups 2 and 3 showed mucoperiostal edema with a predominant reaction of the mucosal layer and lamina propria. Fibrous changes of the processus uncinatus were most often detected after the intervention was performed at 71.43 ± 0.13% and in chronic rhinosinusitis with nasal polyps – 53.85 ± 0.14%. This confirms the significance of the mucoperiostasis injury factor with the underlying bone for the development of gross adhesive changes between the periosteum and bone tissue. Osteitis of the processus uncinatus was detected in 38.46 ± 0.13% of patients in group 2, 15.38 ± 0.1% in group 3, and 28.57 ± 0.17% in group 4. Conclusion. Signs of periostitis and processus uncinatus osteitis were most often detected in patients with neutrophilic mucoperiosteum infiltration in chronic rhinosinusitis with nasal polyps and in fungal balls sinus. History of surgery with periosteal and bone trauma promotes scarring and results in a tight connection between bone and periosteum, which can be regarded as a risk factor in relation to the rupture of the later in its peeling off during sinus lifting procedure. Therefore, when performing surgery on the maxillary sinus, in order to maintain conditions for possible dental implantation, excessive trauma of the periosteal layer of mucoperiosteum should be avoided

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

scholarly journals Isometric Handgrip Exercise Training Improves Spirometric Parameters and Pulmonary Capacity

2021 ◽  
Vol 28 (3) ◽  
pp. 328-338
Author(s):  
Ogbutor Udoji Godsday ◽  
Nwangwa Eze Kingsley ◽  
Nwogueze Bartholomew Chukwuebuka ◽  
Chukwuemeka Ephraim ◽  
Ezunu Emmanuel ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Isometric Exercise ◽  
Handgrip Exercise ◽  
Isometric Handgrip ◽  
Post Exercise ◽  
Significant Difference ◽  
Isometric Handgrip Exercise ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Decline in normal physiological pulmonary function has been attributed to premorbid conditions such as prehypertension. Research evidence suggests that physical activity reduces age-related decline in pulmonary function and improves the efficiency of the lungs in prehypertensive patients. However, there is a scarcity of data evidence relating to isometric exercise and pulmonary function. Furthermore, the interrelationship between the intensity and duration of isometric exercise and pulmonary function in these patients is still uncertain. Therefore, this study was undertaken to investigate the effect of isometric handgrip exercise on pulmonary function capacity in adults with prehypertension. To determine the effectiveness of isometric handgrip exercise on pulmonary function capacity in adults with prehypertension. A quasi experiment using a pre- and post-exercise method was carried out in two out-patients hospital settings. The sample comprised 192 sedentary pre-hypertensive subjects, aged between 30–50 years, that were randomly distributed into three groups of 64 participants each. The subjects performed, for 24 consecutive days, an isometric handgrip exercise at 30% Maximum Voluntary Contraction (M.V.C.). At the end of the 24 days, group one (GP1) discontinued, while group two (GP2) continued the exercise protocol for another 24 consecutive days and group three (GP3) continued with the exercise protocol for another 24 consecutive days but at 50% M.V.C. Determinants of lung function (outcomes) were Forced Expiratory Volume in 1 s (FEV1), Forced Vital Capacity (FVC), FEV1/FVC Ratio and Peak Expiratory Flow Rate (PEFR). The study shows that there was no statistically significant difference in the pre- and post-exercise outcomes for FEV1, FVC, FEV1/FVC Ratio and PEFR after 24 days for group 1. In group 2, there was a statistically significant difference in the FVC [(mean = 0.12 ± 0.12), (p = 0.002)], FEV1 [(mean = 0.15 ± 0.17), (p = 0.003)] and PEF [(mean = 0.85 ± 0.35), (p = 0.001)] after 48 days. In group 3, there was a statistically significant difference (p = 0.001) in all the outcomes assessed after 48 days. There was a between groups difference in favour of group 2 compared with group 1 for outcomes of FEV1 [(mean = 0.142 ± 0.68), (p = 0.005)] and PEF [(mean = 0.83 ± 0.19), (p = 0.0031)]. There was statistically significant difference in favour of group 3 compared to group 2, by increasing the exercise intensity from 30% to 50% M.V.C., for outcomes of FVC [mean change = 0.10 ± 0.052), (p = 0.005)], FEV1/FVC [mean change = 3.18 ± 0.75), (p = 0.017)] and PEF [(mean change = 0.86 ± 0.35), (p = 0.001)] after 48 days. Isometric handgrip exercise (after 48 days at 30% to 50% M.V.C.) improves outcomes of pulmonary function capacity in adults with prehypertension. Meanwhile, duration and/or increase in intensity of the isometric effort significantly contributed to the affects attained.

scholarly journals Effects of posterior tibial slope on the mid-term results of medial unicompartmental knee arthroplasty

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Zhijie Chen ◽  
Kaizhe Chen ◽  
Yufei Yan ◽  
Jianmin Feng ◽  
Yi Wang ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Tibial Slope ◽  
Posterior Tibial ◽  
Significant Difference ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
Group 3 ◽  
Group 2 ◽  
Postoperative Knee ◽  
Group 1

Abstract Objective To evaluate the effect of medial posterior tibial slope (PTS) on mid-term postoperative range of motion (ROM) and functional improvement of the knee after medial unicompartmental knee arthroplasty (UKA). Methods Medical records of 113 patients who had undergone 124 medial UKAs between April 2009 through April 2014 were reviewed retrospectively. The mean follow-up lasted 7.6 years (range, 6.2–11.2 years). Collected were demographic data, including gender, age, height, weight of the patients. Anteroposterior (AP) and lateral knee radiographs of the operated knees were available in all patients. The knee function was evaluated during office follow-up or hospital stay. Meanwhile, postoperative PTS, ROM, maximal knee flexion and Hospital for Special Surgery (HSS) knee score (pre−/postoperative) of the operated side were measured and assessed. According to the size of the PTS, patients were divided into 3 groups: group 1 (<4°), group 2 (4° ~ 7°) and group 3 (>7°). The association between PTS and the knee function was investigated. Results In our cohort, the average PTS was 2.7° ± 0.6° in group 1, 5.6° ± 0.9° in group 2 and 8.7° ± 1.2° in group 3. Pairwise comparisons showed significant differences among them (p < 0.01). The average maximal flexion range of postoperative knees in each group was 112.4° ± 5.6°, 116.4° ± 7.2°, and 117.5° ± 6.1°, respectively, with significant difference found between group 1 and group 2 (p < 0.05), and between group 1 and group 3 (p < 0.05). However, the gender, age, and body mass index (BMI) did not differ between three groups and there was no significant difference between groups in terms of pre−/postoperative HSS scores or postoperative knee ROM. Conclusion A mid-term follow-up showed that an appropriate PTS (4° ~ 7°) can help improve the postoperative flexion of knee. On the other hand, too small a PTS could lead to limited postoperative knee flexion. Therefore, the PTS less than 4° should be avoided during medial UKA.

The Relationship between Serum Ferritin Levels and 5-Year All-Cause Mortality in Hemodialysis Patients

2021 ◽  
pp. 1-7
Author(s):  
Emre Erdem ◽  
Ahmet Karatas ◽  
Tevfik Ecder
Keyword(s):  
Serum Ferritin ◽  
Hemodialysis Patients ◽  
Rank Test ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Group 3 ◽  
Group 2 ◽  
The Relationship ◽  
Group 1

<b><i>Introduction:</i></b> The effect of high serum ferritin levels on long-term mortality in hemodialysis patients is unknown. The relationship between serum ferritin levels and 5-year all-cause mortality in hemodialysis patients was investigated in this study. <b><i>Methods:</i></b> A total of 173 prevalent hemodialysis patients were included in this study. The patients were followed for up to 5 years and divided into 3 groups according to time-averaged serum ferritin levels (group 1: serum ferritin &#x3c;800 ng/mL, group 2: serum ferritin 800–1,500 ng/mL, and group 3: serum ferritin &#x3e;1,500 ng/mL). Along with the serum ferritin levels, other clinical and laboratory variables that may affect mortality were also included in the Cox proportional-hazards regression analysis. <b><i>Results:</i></b> Eighty-one (47%) patients died during the 5-year follow-up period. The median follow-up time was 38 (17.5–60) months. The 5-year survival rates of groups 1, 2, and 3 were 44, 64, and 27%, respectively. In group 3, the survival was lower than in groups 1 and 2 (log-rank test, <i>p</i> = 0.002). In group 1, the mortality was significantly lower than in group 3 (HR [95% CI]: 0.16 [0.05–0.49]; <i>p</i> = 0.001). In group 2, the mortality was also lower than in group 3 (HR [95% CI]: 0.32 [0.12–0.88]; <i>p</i> = 0.026). No significant difference in mortality between groups 1 and 2 was found (HR [95% CI]: 0.49 [0.23–1.04]; <i>p</i> = 0.063). <b><i>Conclusion:</i></b> Time-averaged serum ferritin levels &#x3e;1,500 ng/mL in hemodialysis patients are associated with an increased 5-year all-cause mortality risk.

scholarly journals Multidisciplinary consensus on a stepwise treatment algorithm for management of chronic rhinosinusitis with nasal polyps

2021 ◽  
Author(s):  
Joseph K. Han ◽  
John V. Bosso ◽  
Seong H. Cho ◽  
Christine Franzese ◽  
Kent Lam ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Treatment Algorithm

scholarly journals The Systematic Effect of Mesenchymal Stem Cell Therapy in Critical COVID-19 Patients: A Prospective Double Controlled Trial

2021 ◽  
Vol 30 ◽  
pp. 096368972110249
Author(s):  
G Adas ◽  
Z Cukurova ◽  
K Kart Yasar ◽  
R Yilmaz ◽  
N Isiksacan ◽  
...  
Keyword(s):  
Growth Factors ◽  
Critically Ill ◽  
Inflammatory Cytokines ◽  
Clinical Manifestations ◽  
Systematic Effect ◽  
Cytokine Storm ◽  
Group 3 ◽  
Anti Inflammatory ◽  
Group 2 ◽  
Group 1

The aim of this clinical trial was to control the cytokine storm by administering mesenchymal stem cells (MSCs) to critically-ill COVID-19 patients, to evaluate the healing effect, and to systematically investigate how the treatment works. Patients with moderate and critical COVID-19 clinical manifestations were separated as Group 1 (moderate cases, n = 10, treated conventionally), Group 2 (critical cases, n = 10, treated conventionally), and Group 3 (critical cases, n = 10, treated conventionally plus MSCs transplantation therapy of three consecutive doses on treatment days 0, 3, and 6, (as 3 × 106 cells/kg, intravenously). The treatment mechanism of action was investigated with evaluation markers of the cytokine storm, via biochemical parameters, levels of proinflammatory and anti-inflammatory cytokines, analyses of tissue regeneration via the levels of growth factors, apoptosis markers, chemokines, matrix metalloproteinases, and granzyme-B, and by the assessment of the immunomodulatory effects via total oxidant/antioxidant status markers and the levels of lymphocyte subsets. In the assessment of the overall mortality rates of all the cases, six patients in Group-2 and three patients in Group-3 died, and there was no loss in Group-1. Proinflammatory cytokines IFNγ, IL-6, IL-17A, IL-2, IL-12, anti-inflammatory cytokines IL-10, IL-13, IL-1ra, and growth factors TGF-β, VEGF, KGF, and NGF levels were found to be significant in Group-3. When Group-2 and Group-3 were compared, serum ferritin, fibrinogen and CRP levels in Group-3 had significantly decreased. CD45 +, CD3 +, CD4 +, CD8 +, CD19 +, HLA-DR +, and CD16 + / CD56 + levels were evaluated. In the statistical comparison of the groups, significance was only determined in respect of neutrophils. The results demonstrated the positive systematic and cellular effects of MSCs application on critically ill COVID-19 patients in a versatile way. This effect plays an important role in curing and reducing mortality in critically ill patients.

scholarly journals Microleakage beneath Ceramic and Metal Brackets Bonded with a Conventional and an Antibacterial Adhesive System

2006 ◽  
Vol 76 (6) ◽  
pp. 1028-1034 ◽  
Author(s):  
Neslihan Arhun ◽  
Ayca Arman ◽  
Sevi Burçak Çehreli ◽  
Serdar Arıkan ◽  
Erdem Karabulut ◽  
...  
Keyword(s):  
Adhesive System ◽  
White Spot Lesions ◽  
Adhesive Interface ◽  
Group 4 ◽  
Significant Difference ◽  
Ceramic Brackets ◽  
Group 3 ◽  
Group 2 ◽  
Ceramic Bracket ◽  
Nail Varnish

Abstract Objective: To assess microleakage of a tooth-adhesive-bracket complex when metal or ceramic brackets were bonded with a conventional and an antibacterial self-etching adhesive. Materials and Methods: Forty freshly extracted human premolars were randomly assigned to four equal groups and received the following treatments: group 1 = Transbond XT + metal bracket, group 2 = Transbond XT + ceramic bracket, group 3 = Clearfil Protect Bond + ceramic bracket, and group 4 = Clearfil Protect Bond + metal bracket. After photopolymerization, the teeth were kept in distilled water for 1 month and thereafter subjected to thermal cycling (500 cycles). Specimens were further sealed with nail varnish, stained with 0.5% basic fuchsin for 24 hours, sectioned and examined under a stereomicroscope, and scored for marginal microleakage for the adhesive-tooth and bracket-adhesive interfaces from incisal and gingival margins. Statistical analysis was accomplished by Kruskal-Wallis test and Mann-Whitney U-test with Bonferroni correction. Results: All groups demonstrated microleakage between the adhesive-enamel and bracket-adhesive interfaces. A significant difference was observed among all groups (P &lt; .05) for the microleakage between the bracket-adhesive interface. Metal brackets exhibited significantly more microleakage than did ceramic brackets between the bracket-adhesive interface with either of the adhesives. Clearfil Protect Bond exhibited results similar to Transbond XT. Clearfil Protect Bond may be a choice of adhesive in bracket bonding because of its antibacterial activity and similar microleakage results with the orthodontic adhesive. Conclusions: Metal brackets cause more leakage between an adhesive-bracket interface, which may lead to lower clinical shear bond strength and white-spot lesions.

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