Spatiotemporal Dynamics of Brain Function During the Natural Course in a Dental Pulp Injury Model

Purpose Toothache, a common disorder afflicting most people, shows distinct features at different clinical stages. This study aimed to depict metabolic changes in brain and investigate the potential mechanism involved in the aberrant affective behaviors during the natural process of toothache. Methods We investigated the spatiotemporal patterns of brain function during the natural course of toothache in a rat model of dental pulp injury (DPI) by using positron emission tomography (PET). Results Glucose metabolism peaked on the 3rd day and gradually decreased in several brain regions after DPI, which was in line with the behavioral and histological results. PET imaging showed visual pathway was involved in the regulation of toothache. Meanwhile, the process of emotional regulation underlying toothache was mediated by N-methyl-D-aspartic receptor subunit 2B (NR2B) in the caudal anterior cingulate cortex (cACC). Conclusion Our results revealed the spatiotemporal neurofunctional patterns during toothache process and preliminarily elucidated the role of NR2B in cACC in the regulation of toothache-related affective behaviors.

The Persistence of Natural SARS-CoV-2 Antibodies 12 Months Post COVID-19, a Prospective Cohort Study.

Background: It is unknown how long SARS-CoV-2 antibodies persist after COVID-19. The natural course of anti-SARS-CoV-2 antibodies was analyzed in a large post-COVID-19 cohort, until 12 months post-infection. Methods: The total antibodies SARS-CoV-2 (IgM and IgG) were tested in a cohort of patients with different COVID-19 disease severity sampled at 4 timepoints up to 12 months post COVID-19. In 23 randomly selected patients, the antibody isotypes: anti-spike IgM, IgA and IgG and anti-nucleocapsid IgG were analysed. Results: In total 152/153 patients (99%) tested positive for total anti-SARS-CoV-2 after 12 months of COVID-19; 3 patients tested positive at 8 to 10 months post infection just before vaccination. The SARS-CoV-2 antibody subclasses anti-nucleocapsid IgG, anti-spike IgG and IgA were all still detectable after 12 months. Anti-spike IgM waned after 12 months in the majority of patients.Conclusion: IgG and IgA antibodies against SARS-CoV-2 persisted 12 months post-COVID-19.

445 The long-term natural course of moderate tricuspid regurgitation

Aims The epidemiological and clinical burden of tricuspid regurgitation (TR) has lately gained much attention from the scientific community. In fact, recent epidemiological studies report a prevalence of moderate and severe TR in population over the age of 65 screened for valve disease ranging from 2.7% to 4%, with an independent prognostic role clearly worsening long-term survival along with the increasing severity of TR grade. Particularly, as TR is often clinically unsuspected until an advanced stage of congestive heart failure (HF), there is a great need of early diagnosis and long-term appropriate follow-up and management. Nonetheless, data focusing on the clinical and echocardiographic course of a cohort of patients suffering from moderate TR, although eagerly awaited, are lacking. To evaluate and clarify the evolution and the long-term independent clinical outcome of a cohort of patients suffering from moderate functional or organic TR. Methods We electronically searched for ambulatory and in-patients who underwent transthoracic and/or transesophageal echocardiography with a diagnosis of moderate TR, along with a complete clinical evaluation, in our centre between January 2014 and December 2019. Patients were considered eligible if a second echocardiographic examination including a careful evaluation of the severity of TR and clinical information were available for a minimum follow-up of 6 months. The primary endpoint was all-cause mortality; secondary endpoints were hospitalization for HF and TV intervention, either surgical or percutaneous. Results We enrolled 130 patients, predominantly female with multiple comorbidities, cardiovascular risk factors and history of atrial fibrillation; TR aetiology was functional in most cases (93 patients, 72%). Over a mean follow-up of 5 years, TR grade progressed to at least severe in 55 patients (42%): at multivariate analyses, diabetes mellitus (P=0.003), anaemia (P=0.03) and at least moderate mitral regurgitation or aortic stenosis (P=0.039) were all predictors of TR severity progression. The primary endpoint occurred in 41(32%) of patients and was significantly more frequent (P<0.0001) in patients with severe TR at follow-up compared to those without TR severity progression. HF hospitalization and TV intervention occurred in 47 (36%) and 20 (14%) of patients: again, both were significantly more frequent in patients with severe TR (P=0.0008 and P=0.02, respectively) in comparison to those without worsened TR severity at follow-up. Conclusions Our results show that moderate TR, over a long-term follow-up period, worsens to at least severe grade in a relevant proportion of patients, conveying a significant independent risk of hard events such as all-cause death, HF hospitalization and TV intervention. Therefore, this cohort of patients should be appropriately managed and closely followed-up in order to avoid adverse clinical events related to the natural course of this valvulopathy.

A Retrospective Clinicoradiologic Study of 126 Cerebellopontine Angle Tumors to Predict the Outcome of House–Brackmann Status to Prognosticate Them: A Single-Center Tertiary Care Perspective

Introduction House–Brackmann (HB) grading had been described to quantify the facial nerve involvement in cerebellopontine angle (CPA) tumors, a very common tumor in neurosurgical practice. Very few studies have specifically looked into the factors predicting the facial nerve morbidity and its severity. Here, we try finding these while going through the clinicoradiologic factors and its natural course to help us prognosticate the patients. Objective To analyze the size of tumor and duration of symptoms to predict the severity of HB status of facial nerve presentation and outcome, and to study the course of the disease to help prognosticate the patients with respect to facial nerve status. Materials and Methods This was a retrospective analysis of 126 operated CPA tumors, where we studied the natural course of HB status with respect to size and duration of symptoms of patients at our institute between December 2016 to February 2020. Results Average duration of symptoms were 33.8 days with increasing risk of HB outcome after 36 days of symptoms. All patients improved to their preoperative facial nerve status at 3 months and only 18 maintained the worsened HB status. Average size of tumor was 3.53 cm, and size higher than 3.8 cm was associated with poorer HB outcome. Conclusion Although there can be a significant deterioration of HB status in immediate postoperative period, it improves to preoperative status in due time. Tumor larger than 3.8 cm and symptom duration more than 36 days are two important factors predicting poorer HB outcome.