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Πέμπτη 24 Ιουνίου 2021

Comparison of the effect of ginger and aloe vera mouthwashes on xerostomia in patients with type 2 diabetes: A clinical trial, triple-blind

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Med Oral Patol Oral Cir Bucal. 2021 Jun 24:23998. doi: 10.4317/medoral.23998. Online ahead of print.

ABSTRACT

BACKGROUND: Ginger and aloe vera are two medicinal herbs mostly used to produce mouthwash. This study aimed to compare the effects of ginger and aloe vera mouthwashes on the xerostomia in patients referred to Bandar Abbas diabetes clinic (Iran).

MATERIAL AND METHODS: In this triple-blind clinical trial, three groups (n=35 patients in each group) were studied. One group was given aloe vera mouthwash, the other group used ginger mouthwash, and the control group was only given normal saline. All the mouthwashes were used 20 ccs three times daily for 14 consecutive days. The symptoms and severity of xerostomia were measured before and after the intervention by the questionnaire proposed by Fox et al. as well as VAS scale, respectively. Statistical analysis, including the Shapiro-Wilk test used to measure the normality of vari ables, and Chi-square and McNemar used to compare the scores questionnaire proposed by Fox et al., were also applied. Scores of VAS were analyzed using a one-way ANOVA test. P<0.05 was considered as statistically significant in all these tests.

RESULTS: The mean age of the participants included in the normal saline group was 58.13±14.75 years old, 54.14±9.35 years old in the ginger group, and 53.37±11.57 years old in the aloe vera group. The difference between the scores of xerostomia before and after performing the intervention (The amount of reduction in xerostomia) in the ginger group was 6.12±2.004 cm, in the aloe vera group it was 4.08±2.09 cm, and in the normal saline group it was 2.45±2.09 cm. Finally, the ginger and aloe vera mouthwashes significantly reduced all symptoms and severity related to xerostomia, respectively(p<0.001).

CONCLUSIONS: The use of mouthwash is an effective measure to reduce xerostomia under chronic conditions. Aloe vera, ginger, and normal saline are known as effective mouthwashes on controlling this complication. According to the results of this study, ginger and aloe vera mouthwashes could significantly decrease xerostomia and promote oral health in patients with diabetes.

PMID:34162822 | DOI:10.4317/medoral.23998

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Juvenile ossifying fibroma of the maxillofacial region: analysis of clinico-pathological features and management

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Med Oral Patol Oral Cir Bucal. 2021 Jun 24:24592. doi: 10.4317/medoral.24592. Online ahead of print.

ABSTRACT

BACKGROUND: The diagnosis and management of juvenile ossifying fibroma (JOF) remains a highly debated topic with paucity of studies with long-term follow-up, hence the aim of this study was to report on the clinico-pathological features and management of these neoplasms.

MATERIAL AND METHODS: A retrospective analysis was performed on all histopathologically confirmed JOF presenting at two tertiary hospitals in Cape Town, South Africa over a period of 39 years. Clinical, demographic, histopathological and radiological features were analyzed. Surgical methods were documented and a minimum post-operative follow-up of 12 months was a prerequisite.

RESULTS: Seventeen patients met the inclusion criteria and were included in this study. Overall, the ages of patients ranged from 3-31 years (mean= 13 years) with male to fema le ratio of 1.8:1. The ages of patients diagnosed with Trabecular JOF were significantly younger than patients with Psammomatoid JOF (P = 0.01). The majority of patients presented with marked swelling (88.2%). Interestingly, most neoplasms occurred in the mandible (76.5%) with all Psammomatoid JOF uncharacteristically occurring in the mandible. There was only one case of Trabecular JOF occurring in the sinonasal area. Most neoplasms appeared as unilocular (76.5%) and well-defined (82.4%) with mixed radio-density (70.6%) on radiographs and computed tomography. Curettage with peripheral ostectomy was shown to be the least invasive method with an acceptable recurrence rate (10%). Six lesions underwent resection without any recurrences however caused high morbidity to these young patients.

CONCLUSIONS: The high number of lesions occurring in the mandible for both variants of JOF demonstrates that site should not be a major determining factor in the diagnosis of JOF. Moreover, cure ttage with peripheral ostectomy should be used as the first line of management to minimize morbidity to the patient and that resection should be reserved for large and recurrent lesions.

PMID:34162821 | DOI:10.4317/medoral.24592

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Effect of bone loss on the fracture resistance of narrow dental implants after implantoplasty. An in vitro study

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Med Oral Patol Oral Cir Bucal. 2021 Jun 24:24624. doi: 10.4317/medoral.24624. Online ahead of print.

ABSTRACT

BACKGROUND: Implantoplasty (IP) involves polishing of the exposed surface of implants affected by peri-implantitis (PI). A study was made to determine whether the degree of bone loss influences the fracture resistance of implants with or without IP.

MATERIAL AND METHODS: An in vitro study was carried out on 32 narrow (3.5 mm) dental implants with a rough surface and external hexagonal connection. Implantoplasty was performed in half of the implants of the sample. Both the IP and control implants were divided into two subgroups according to the amount of bone loss (3 mm or 7.5 mm). Standardized radiographic assessment of implant width was performed using specific software. The main outcome variable was the maximum compression force (Fmax) of implants when subjected to static resistance to fracture tests. Implant fractures were subsequently analyzed by scanning electron microscopy. A descriptive and bivariate analysis of the data was performed.

RESULTS: Significant changes in implant width were observed after IP (p<0.05). No significant differences between IP and control implants were recorded in terms of the Fmax values in the two bone loss subgroups (3 mm: control 854.37N 195.08 vs. IP 752.12N 186.13; p=0.302, and 7.5 mm: control 548.82N 80.02 vs. IP 593.69N 111.07; p=0.370). Greater bone loss was associated to a decrease in Fmax, which proved significant for the control implants (p=0.001). Fractures were more frequently located in the platform (n=13).

CONCLUSIONS: Implants with more apical bone levels appear to be more susceptible to fracture. On the other hand, IP does not seem to significantly decrease the fracture resistance of narrow (3.5 mm) platform dental implants with external hexagonal connections. The fact that most fractures occur in the platform area indicates that the la tter is exposed to more mechanical stress.

PMID:34162823 | DOI:10.4317/medoral.24624

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Clinicopathologic features of nasopalatine duct cysts: A retrospective study in two Brazilian oral and maxillofacial pathology referral centers

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Med Oral Patol Oral Cir Bucal. 2021 Jun 24:24718. doi: 10.4317/medoral.24718. Online ahead of print.

ABSTRACT

BACKGROUND: Nasopalatine duct cyst (NDC) is the most common non-odontogenic cyst in the oral cavity. Clinically it is not difficult to suspect these lesions based on clinical and radiographic appearance. However, the histopathological diagnosis may be difficult due to the broad morphological diversity of these lesions. The objective was to analyze the clinicopathological features of NDCs diagnosed in two oral and maxillofacial pathology services in the Brazilian northeast.

MATERIAL AND METHODS: A retrospective clinicopathologic study was performed. A total of 18,121 clinical records of oral lesions from two oral and maxillofacial pathology services in Brazil were analyzed (2000-2020). All NDCs cases were revised and demographic, clinical, radiographic, and histopathological data were collected.

RESULTS: Among 18,121 diagnoses in the oral pathology services, 45 (0.2%) were NDCs. The series comprises 24 males (53.3%) and 21 females (46.7%), with a mean age of 43.2 years-old. Most lesions were asymptomatic (n = 27, 60%) with an mean size of 2.1 cm. Microscopically, the non-keratinized stratified squamous epithelium was the most common (66.7%). However, in 88.9% of cases, the epithelial lining was varied and composed of two or more types of epithelium. There was no significant association between the type of epithelium and the size of the cysts (p = 0.389). Nerve, blood vessels, hemorrhage, and chronic inflammatory infiltrate were commonly observed. In contrast, there was a low frequency of mucous glands, sebaceous glands, cholesterol clefts, and multinucleated giant cells.

CONCLUSIONS: The clinical, radiographic, and microscopic findings observed in this study are similar to those reported in the literature. Due to the morphological diversity of NDC, it is needed to correlate its histopatho logical features with the clinical and radiographic findings to establish a correct diagnosis.

PMID:34162820 | DOI:10.4317/medoral.24718

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Dysplasia in oral lichen planus: relevance, controversies and challenges. A position paper

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Med Oral Patol Oral Cir Bucal. 2021 Jun 24:24610. doi: 10.4317/medoral.24610. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with oral lichen planus (OLP) have an increased risk of oral cancer. For this reason, OLP is classified as an oral potentially malignant disorder. However, the precise personal (or individual) risk is unknown. Recent meta-analytical studies have reported that dysplastic OLP may transform to cancer in around 6% of cases, while the rate of transformation is lower (<1.5%) in non-dysplastic cases. The presence of epithelial dysplasia has emerged as the most powerful indicator for assessing cancer risk in oral potentially malignant disorders in routine practice. However, the general acceptance of epithelial dysplasia as an accompanying histologic feature in OLP is subject to great controversy. Many pathologists consider the presence of dysplasia as a criterion to exclude OLP when routinely reporting on this d isease. This practice, widespread among oral pathology professionals, has resulted in the underestimation of the potential for malignancy of OLP.

MATERIAL AND METHODS: A review of the literature was carried out in order to critically analyze the relevance, controversies and challenges encountered across the diagnosis of epithelial dysplasia in OLP.

RESULTS: 12 studies have been published examining dysplastic changes in OLP, reporting figures ranging from 0.54% to 25% of cases with dysplasia in the first diagnostic biopsy. The diagnosis of dysplasia in the OLP poses an additional difficulty due to the fact that the affected oral epithelium per se develops changes related to autoimmune aggression. Among the most frequent histological features of OLP that develops dysplasia are basal cell hyperplasia with basaloid appearance, loss of basal cells polarity, cellular and nuclear pleomorphism and irregular stratification.

CONCLUSIONS: Epithelial dysplasia should not be co nsidered an exclusion criterion for OLP; its evaluation requires experienced pathologists in this field.

PMID:34162824 | DOI:10.4317/medoral.24610

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Online audio-visual information on oral cancer for Spanish-speaking laypersons. A cross-sectional study

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Med Oral Patol Oral Cir Bucal. 2021 Jun 24:24770. doi: 10.4317/medoral.24770. Online ahead of print.

ABSTRACT

BACKGROUND: Lack of knowledge and awareness of oral cancer seem to be the main causes of diagnostic delay. Online resources are often used by patients to obtain health/medical information. However, there are no reports on the quality and usefulness of oral cancer audio-visual resources in Spanish. The aims of this investigation were to disclose the type of information about oral cancer available, and whether it may be useful to shorten the patients' oral cancer appraisal time-interval.

MATERIAL AND METHODS: Cross-sectional study undertaken at three video-sharing sites on October, 13th 2019.

KEYWORDS: "Cáncer oral"; "cáncer de boca". The first 100 results in each viewing list were retrieved by three reviewers. Demographical data was recorded, and interaction indexes, viewing rates, comprehensiveness, and usefulness were calculated for each video. The presence of non-scientifically supported information was also assessed. A descriptive analysis was undertaken, and relationships between variables were explored using the Spearman correlation test.

RESULTS: A total of 127 videos were selected. They were produced mainly by mass-media (46.5%; n=59) and their length ranged from 0.28 to 105.38 minutes (median 4.15 minutes; IQR: 2.34-9.67). The most viewed video (10,599,765 views; visualization rate 726,508.9) scored 0 both in usefulness and comprehensiveness. The most useful video gathered 44,119 views (visualization rate 2.033.13). A highly significant positive correlation (0.643; p<0.001) could be observed between usefulness and comprehensiveness of the videos, together with negative correlations between the visualization rate and usefulness (-0.186; p<0.05), and visualization rate and comprehensiveness (-0.183; p<0.05).

CONCLUSIONS: Online audio-visual material about oral canc er in Spanish is incomplete, of limited usefulness, and often includes non-scientifically supported information. Most of these resources are produced by mass media and healthcare professionals, with minor contributions from educational and healthcare institutions. Visualization rates negatively correlated with the usefulness and comprehensiveness of the contents in these digital objects.

PMID:34162818 | DOI:10.4317/medoral.24770

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A review of the research progress of interventional medical equipment and methods for prostate cancer

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Abstract

Background

Prostate cancer is a common disease in men and has a relatively high mortality rate. However, the interventional medical equipment used for prostate biopsy and brachytherapy has always been a social concern.

Methods

To understand interventional medical equipment for prostate cancer, the structure of manual, semi-automatic, and automatic medical equipment were considered as the mainline, while the corresponding research on these structures were the auxiliary lines. The characteristics and corresponding research status have been discussed.

Results

Interventional medical equipment for prostate cancer with different degrees of automation and its characteristics were determined, and the imaging principles and characteristics of computed tomography, transrectal ultrasound, and magnetic resonance imaging have been briefly described.

Conclusion

Certain feasible research suggestions have been proposed for future development from the perspective of structure, accuracy, and safety. These include flexible and compact robot structures, high-precision image recognition and guidance, accurate dose planning and monitoring, real-time imaging monitoring without delay, high-precision needle insertion strategy, master-slave control, virtual reality, and remote control.

This article is protected by copyright. All rights reserved.

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A case report of concurrence of aberrant extracranial internal carotid artery and nonrecurrent laryngeal nerve in a patient of advanced thyroid carcinoma invading hypopharynx

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Gland Surg. 2021 May;10(5):1786-1791. doi: 10.21037/gs-20-663.

ABSTRACT

Aberrant extracranial internal carotid artery and nonrecurrent laryngeal nerve (NRLN) are neurovascular anomalies, which clinicians should be aware of to prevent severe complications while performing transoral or open surgery in the head and neck area. These two variants can occur simultaneously because of similar etiology of embryological maldevelopment of arch arteries. In this study, a 64-year-old woman comp laining of hoarseness presented a bulge in the left hypopharynx. A contrasted computed tomography scan indicated left thyroid mass with hypopharynx invasion, accompanied by right aberrant extracranial internal carotid artery and subclavian artery. Fine needle aspiration biopsy of the mass revealed papillary thyroid carcinoma (PTC). She underwent total thyroidectomy, partial hypopharyngectomy, neck dissection, and tracheotomy. Intraoperatively, a right NRLN was found above the level of the cricothyroid junction that entered the larynx. The patient did not present severe complications postoperatively. Radioactive iodine therapy was applied after the surgery. At the 3-year follow-up, she remained cancer-free, and the hoarseness has improved. This is the first report of concurrent aberrant extracranial internal carotid artery and NRLN. NRLN of right side can be predicted in the computed tomography scan by the sign of the right subclavian artery origining from the left side of the aortic arch and running an abnormal course between the esophagus and the vertebra. Meanwhile, aberrant extracranial internal carotid artery may occur simultaneously. Recognition of aberrant neurovascular structures enables clinicians to prevent severe surgical complications.

PMID:34164322 | PMC:PMC8184399 | DOI:10.21037/gs-20-663

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Clinical Analysis of the Short-Term Outcome of Papillary Thyroid Micro Carcinoma After 131I Treatment

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Cancer Manag Res. 2021 Jun 14;13:4691-4698. doi: 10.2147/CMAR.S308012. eCollection 2021.

ABSTRACT

PURPOSE: To explore the factors that influence the short-term clinical outcome after the first 131I treatment of papillary thyroid micro carcinoma (PTMC).

PATIENTS AND METHODS: From October 2015 to June 2018, patients who were diagnosed with PTMC with lymph node metastasis were analyzed retrospectively, excluding patients with incomplete clinical data, distant metastas is, positive TGAb, TSH<30 mIU/L. The baseline data of sex, age, time from last surgery to first 131I treatment, tumor pathology information, and biochemical information were collected before admission. All patients included had radioactive iodine (RAI) with 3.70 GBq. The treatment response of patients was evaluated 6-8 months after discharge. By means of univariate and multivariate analysis, including excellent response (ER) and non-excellent response (NER) groups of clinical data, we assessed the impact of 131I on patients' outcome. A nomogram model was established based on the above independent risk factors.

RESULTS: A total of 206 patients (59 males and 147 females, mean age 43.4 ± 10.6 years) were included in the study. The median follow-up time was 169.4 ± 10.5 days, including 139 patients in ER group (67.4%) and 67 patients in NER group (32.5%). Four factors including combining Hashimoto's thyroiditis, pre-ablative Tg levels, UIE levels, and la teral lymph node numbers were statistically different between ER group and NER group with significance at P < 0.05. Further multivariate analysis showed that Hashimoto's thyroiditis and Ps-Tg levels could be used as independent factors. The model verification showed that the C-index of the modeling set was 0.822, indicating that the nomogram model had a good predicted accuracy.

CONCLUSION: Our data suggest that coexisting Hashimoto's thyroiditis and elevated Ps-Tg levels are predictive factors for short-term outcome of thyroid micro papillary carcinoma after 131I treatment. Also, the nomogram model had a good predicted accuracy.

PMID:34163244 | PMC:PMC8214364 | DOI:10.2147/CMAR.S308012

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Asthma increased in young adults from 2008–2016 despite stable allergic rhinitis and reduced smoking

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Via Rhinitis

journal.pone.0253322.g003&size=inline

by Styliana Vasileiadou, Linda Ekerljung, Anders Bjerg, Emma Goksör

Background

Studies have produced inconsistent results on prevalence trends in asthma and allergic rhinitis (AR). We surveyed young adults about asthma in 2008 and 2016 and examined the impact of gender, AR and smoking.

Methods

Thirty-thousand randomly selected subjects aged 16–75 years in Western Sweden received postal questionnaires in 2008 and 50,000 in 2016. This study is based on responders aged 16–25 years, 2,143 in 2008 and 2,484 in 2016.

Results

From 2008–2016 current asthma increased from 9.3% to 11.5% (p = 0.014) and was significant in males without AR (aOR 1.83, 95% CI 1.09–3.07) and male smokers (aOR 3.02, 95% CI 1.12–8.13). In both years the risk of current asthma was reduced by growing up on a farm (aOR 0.26, 95% CI 0.81–0.84 and aOR 0.47, 95% CI 0.23–0.996), independent of a family history of asthma or allergy. AR did not differ significantly from 2008–2016 (22.5% vs 24.4%, p = 0.144). Current smoking decreased from 20.3% to 15.2% (p Con clusion

Current asthma increased in respondents aged 16–25 from 2008–2016, mainly among males without AR and male smokers. Current AR levelled off in this young population, while current smoking decreased among females.

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