Early maladaptive schemas and ICD‐11 CPTSD symptoms: Treatment considerations

alexandrossfakianakis shared this article with you from Inoreader Early maladaptive schemas and ICD‐11 CPTSD symptoms: Treatment considerations via Psychology and Psychotherapy: Theory, Research and Practice Abstract Objectives Early maladaptive schemas (EMS) can result from adverse interpersonal traumatic experiences. The ICD-11 updated the concept of disorders following traumatic experiences with the new disorder of complex post-traumatic stress disorder (CPTSD). There is now a need to develop and test interventions for CPTSD. An essential step in identifying interventions that are particularly relevant to the treatment of CPTSD is to explore psychological constructs associated more closely with CPTSD compared to PTSD. The current study explored the associations of EMS with PTSD and CPTSD. Design The sample consisted of 603 adults (mean age = 41.65, SD = 13.8), recruited through social media and e-mails, and who responded to an online questionnaire. Methods Participants completed measures of demographic, traumatic life events, EMS, PTSD and CPTSD symptoms. Results Overall, results suggest that participants with CPTSD present with higher schema elevations across all schemas compared to those with PTSD or no diagnosis. Secondly, the schemas of emotional deprivation, abandonment/instability, social isolation/alienation, defectiveness/shame, enmeshment/undeveloped self, subjugation, emotional inhibition and insufficient self-control/self-discipline were significantly associated with the symptom clusters of CPTSD. Finally, results indicate that different schemas form significant associations with the individual symptom clusters of CPTSD. Conclusions Although results require replication in clinical samples, initial findings suggest that specific EMS may be important psychological correlates of CPTSD symptoms. Wider treatment considerations of these findings are discussed. View on Web

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Long-term Traffic-related Air Pollutant Exposure and Amyotrophic Lateral Sclerosis Diagnosis in Denmark: A Bayesian Hierarchical Analysis

alexandrossfakianakis shared this article with you from Inoreader Long-term Traffic-related Air Pollutant Exposure and Amyotrophic Lateral Sclerosis Diagnosis in Denmark: A Bayesian Hierarchical Analysis via Epidemiology - Current Issue Background: Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease. Limited evidence suggests ALS diagnosis may be associated with air pollution exposure and specifically traffic-related pollutants. Methods: In this population-based case–control study, we used 3,937 ALS cases from the Danish National Patient Register diagnosed during 1989–2013 and matched on age, sex, year of birth, and vital status to 19,333 population-based controls free of ALS at index date. We used validated predictions of elemental carbon (EC), nitrogen oxides (NOx), carbon monoxide (CO), and fine particles (PM2.5) to assign 1-, 5-, and 10-year average exposures pre-ALS diagnosis at study participants' present and historical residential addresses. We used an adjusted Bayesian hierarchical conditional logistic model to estimate individual pollutant associations and joint and average associations for traffic-related pollutants (EC, NOx, CO). Results: For a standard deviation (SD) increase in 5-year average concentrations, EC (SD = 0.42 µg/m3) had a high probability of individual association with increased odds of ALS (11.5%; 95% credible interval [CrI] = –1.0%, 25.6%; 96.3% posterior probability of positive association), with negative associations for NOx (SD = 20 µg/m3) (–4.6%; 95% CrI = 18.1%, 8.9%; 27.8% posterior probability of positive association), CO (SD = 106 µg/m3) (–3.2%; 95% CrI = 14.4%, 10.0%; 26.7% posterior probability of positive association), and a null association for nonelemental carbon fine particles (non-EC PM2.5) (SD = 2.37 µg/m3) (0.7%; 95% CrI = 9.2%, 12.4%). We found no association between ALS and joint or average traffic pollution concentrations. Conclusions: This study found high probability of a positive association between ALS diagnosis and EC concentration. Further work is needed to understand the role of traffic-related air pollution in ALS pathogenesis. View on Web

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Long-term Exposure to Oxidant Gases and Mortality: Effect Modification by PM2.5 Transition Metals and Oxidative Potential

alexandrossfakianakis shared this article with you from Inoreader Long-term Exposure to Oxidant Gases and Mortality: Effect Modification by PM2.5 Transition Metals and Oxidative Potential via Epidemiology - Current Issue Background: Populations are simultaneously exposed to outdoor concentrations of oxidant gases (i.e., O3 and NO2) and fine particulate air pollution (PM2.5). Since oxidative stress is thought to be an important mechanism explaining air pollution health effects, the adverse health impacts of oxidant gases may be greater in locations where PM2.5 is more capable of causing oxidative stress. Methods: We conducted a cohort study of 2 million adults in Canada between 2001 and 2016 living within 10 km of ground-level monitoring sites for outdoor PM2.5 components and oxidative potential. Ox exposures (i.e., the redox-weighted average of O3 and NO2) were estimated using a combination of chemical transport models, land use regression models, and ground-level data. Cox proportional hazards models were used to estimate associations between 3-year moving average Ox and mortality outcomes across strata of transition metals and sulfur in PM2.5 and three measures of PM2.5 oxidative potential adjusting for possible confounding factors. Results: Associations between Ox and mortality were consistently stronger in regions with elevated PM2.5 transition metal/sulfur content and oxidative potential. For example, each interquartile increase (6.27 ppb) in Ox was associated with a 14.9% (95% CI = 13.0, 16.9) increased risk of nonaccidental mortality in locations with glutathione-related oxidative potential (OPGSH) above the median whereas a 2.50% (95% CI = 0.600, 4.40) increase was observed in regions with OPGSH levels below the median (interaction P value View on Web

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Laryngopharyngeal Symptoms and Esophageal Disorder: The Role of Heterotopic Gastric Mucosa in Upper Esophagus

alexandrossfakianakis shared this article with you from Inoreader Laryngopharyngeal Symptoms and Esophageal Disorder: The Role of Heterotopic Gastric Mucosa in Upper Esophagus via Clinical Otolaryngology Abstract Background Heterotopic gastric mucosa in the upper esophagus (HGMUE) was considered as geneogenous manifestation. However, its clinical characteristics may beyond to our knowledge if we focus on its extra-esophageal presentation. So the aim of this study was to investigate the relationship between HGMUE and laryngopharyngeal symptoms. Method Eight hundred and eleven patients who had gastric endoscopy examination were enrolled in this study and the cervical esophagus was examined for the patch during withdrawal of the endoscope. Questionnaire for gastroesophageal reflux disease (GERD-Q) and Reflux Symptom Index (RSI) were completed by all the patients. Pathology feature and therapeutic effect of HGMUE patients were evaluated. Result About 34.53% of the patients undergoing the gastroduodenoscopy had laryngopharyngeal (LP) symptoms. The relevance rate of HGMUE in LP(+)group(10.69%) was higher than that in LP(-) group(2%). The LP symptoms were related to the histological type and expression of H+-K+-ATPase in the histological sample of HGMUE patients. The positive rate of H+-K+-ATPase was 100% in LP(+) group, and that in LP(-) group was 28.6%. PPI therapy was effective for improving the LP symptoms in HGMUE patients. The RSI score in LP(+) patients decreased from 8.12±1.46 at baseline to 4±0.74 at the end of 8 weeks after treatment of PPI. Conclusion HGMUE was an important cause of LP symptoms in patients, especially in those who had no evidence of GERD. The mechanism of HGMUE induced LP symptoms was due to its location and the function of acid secretion according to the endoscopic finding and histologic characteristics. View on Web

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Characterization and application of a series of monoclonal antibodies against SARS‐CoV‐2 nucleocapsid protein

alexandrossfakianakis shared this article with you from Inoreader Characterization and application of a series of monoclonal antibodies against SARS‐CoV‐2 nucleocapsid protein via Journal of Medical Virology Abstract The ongoing coronavirus disease 2019 (COVID-19) pandemic has a significant global social and economic impact, and the emergence of new and more destructive mutant strains highlights the need for accurate virus detection. Here, 90 monoclonal antibodies (MAbs) that exclusively reacted with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid protein (NP) were generated. These MAbs did not cross-react with NPs of common human coronaviruses (HCoV, i.e., 229E, OC43, HKU1, and NL63) and Middle East Respiratory Syndrome Coronavirus. Subsequently, overlapped peptides in individual fragments (N1–N4) of NP were synthesized. N1-3 (25-GSNQNGERSGARSKQ-39), N3-1 (217-AALALLLLDRLNQL-230), and N4-8 (393-TLLPAADLDDFSKQL-407) were identified as major epitopes using enzyme-linked immunoassay (ELISA) and recognized by 47, 1, and 18 MAbs, respectively. The 24 remaining MAbs exhibited no reactivity with all synthetic peptides. Among MAb-epitope pairs, only MAbs targeting epitope N1-3 displayed no cross-reaction with NPs of SARS-CoV-1 and other SARS-related CoVs. All omicron variants contained a three-amino acid deletion (31ERS33) in the N1-3 region. Thus, MAbs targeting N1-3 failed to recognize these variants. Furthermore, a double-antibody sandwich ELISA for antigen detection was established using the optimal MAbs. Overall, a series of MAbs targeting SARS-CoV-2 NP was prepared, characterized with epitope mapping, and applied for the detection of SARS-CoV-2 antigens, and some novel B-cell epitopes of the viral NP were identified. This article is protected by copyright. All rights reserved. View on Web

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Triple Antibiotic Paste Composition and use in Root Canal Treatment

alexandrossfakianakis shared this article with you from Inoreader Triple Antibiotic Paste Composition and use in Root Canal Treatment via Junior Dentist Triple Antibiotic Paste is a type of Intra Canal Medicament which is used in Endodontic Treatment or Root canal Treatment to kill the micro organisms in the periapical region of an infected Root Canal. Triple antibiotic Paste or (TAP) consists of three medicines - Metronidazole, Ciprofloxacin and Minocycline. This combinati on of medicines have been found to be the best regimen to eliminate root canal pathogens. The most common microorganisms found in infected Root Canals are Peptostreptococcus spp, Actinomyces, Staphylococcus Salivarius, S. Sanguis, P. Endodontalis. The micro organisms most commonly infecting Failed or Re-infected root canals are "Enterococcus Faecalis". Triple Antibiotic paste uses: It is used as an Intracanal Medicament and in Regenerative Endodontics (Pulp Capping). It has been found to be very effective against E Feacalis which is a very stubborn bacteria found in Re-infected root canals. Composition of Triple antibiotic Paste: TAP is a combination of three antibiotics - Minocycline + Ciprofloxacin + Metronidazole. A combination of three antibiotics is required as any Infection of the Root Canal consists of multiple microorganisms of different types and to treat all these bacteria any single Antibiotic is sometimes not enough. A Combination of Antibiotics usually helps in treating the diverse flora of the Root Canal. How is Triple Antibiotics Paste prepared: Hoshino et al. first proposed the combination of TPA and mentioned that the three Antibiotics - Metronidazole (500 mg) 30% + Minocycline (100mg) 30% + Ciprofloxacin (200mg) 30% + Propylene Glycol paste 10% should be mixed in a ratio of 1:1:1. These three components should have a carrier Glycol and macrogol ointment in a ratio of 1:1. The combination was later modified by making changes in the Ratios by Takushige et al. who proposed that the ratios should be Metronidazole + Minocycline + Ciprofloxacin - 3:3:1. A new Intra Canal Medicament known as MTAD was found to be useful in eliminating Enterococcus Faecalis strains  in a study published by Newberry et al. The MTAD is a combination of 3% Doxycycline, Citric Acid and a detergent polysorbate 80. MTAD should be used as an irrigation fluid inside the canals. MTAD should be used as the final irrigation rinse after using 1.3% Naocl and Saline. This has been found to remove the smear layer without altering the structure of dentinal tubules. View on Web

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A Nationwide Evaluation of Bevacizumab-based Treatments in Paediatric Low-Grade Glioma in the UK: Safety. Efficacy, Visual Morbidity and Outcomes

alexandrossfakianakis shared this article with you from Inoreader A Nationwide Evaluation of Bevacizumab-based Treatments in Paediatric Low-Grade Glioma in the UK: Safety. Efficacy, Visual Morbidity and Outcomes via Neuro-Oncology Advance Access Abstract Background Bevacizumab is increasingly used in children with Paediatric Low-Grade Glioma (PLGG) despite limited evidence. A nationwide UK service evaluation was conducted to provide larger cohort 'real life' safety and efficacy data including functional visual outcomes. Methods Children receiving Bevacizumab-based treatments (BBT) for PLGG (2009-2020) from 11 centres were included. Standardised neuro-radiological (RANO-LGG) and visual (logMAR visual acuity) criteria were used to assess clinical-radiological correlation, survival outcomes and multivariate prognostic analysis. Results Eighty-eight children with PLGG received BBT either as 3 rd line with Irinotecan (85%) or alongside 1 st/2 nd line chemotherapies (15%). Toxicity was limited and minimal. Partial response (PR, 40%), stable disease (SD, 49%), and progressive disease (PD, 11%) were seen during BBT. However, 65% progressed at 8 months (median) from BBT cessation, leading to a radiology-based 3yr-progression-free survival (PFS) of 29%. Diencephalic syndrome (p= 0.03) was associated with adverse PFS. Pre-existing visual morbidity included unilateral (25%) or bilateral (11%) blindness. Improvement (29%) or stabilisation (49%) of visual acuity were achieved, more often in patients' best eyes. Vision deteriorated during BBT in 14 (22%), with 3-year visual-PFS of 53%; more often in patients' worst eyes. A superior visual outcome (p=0.023) was seen in Neurofibromatosis type 1-associated Optic Pathway Glioma (OPG). Concordance between visual and radiological responses was 36%; optimised to 48% using only best eye responses. Conclusions BBTs provide effective short-term PLGG control and delay further progression, with a better sustained visual (best >worst eye) than radiological response. Further research could optimise the role of BBTs towards a potentially sight-saving strategy in OPG. View on Web

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The Role of Fluorescent Angiography in Free Flap Reconstruction of the Head and Neck

alexandrossfakianakis shared this article with you from Inoreader The Role of Fluorescent Angiography in Free Flap Reconstruction of the Head and Neck via The Laryngoscope A retrospective study of the use of fluorescent angiography in free flap reconstruction of the head and neck shows that although the use of this technology in every free tissue transfer is not justifiable, it can guide the clinical course in challenging scenarios. Objectives Highlight the use of fluorescent angiography in free flap reconstruction of the head and neck. Qualify how fluorescent angiography can be selectively added to management paradigms for head and neck free flap reconstruction. Methods Retrospective chart review of 993 free flaps completed from the time the SPY Elite® system first became available at our institution between September 2013, until August 2020. Cases that used the SPY Elite® system were grouped into three broad categories: evaluation during initial flap harvest while still attached to the donor site, evaluation after anastomosis in the head and neck area, and evaluation post-operatively for questionable flap viability. Results The SPY Elite® system was used in 64 cases. Forty flaps were evaluated intraoperatively during initial harvest and before anastomosis to the head and neck area. Of these, 20 had signs of poor perfusion of the entire skin paddle, 12 had large myogenous or skin flaps with questionable perfusion of the distal aspect, and 8 were evaluated for other reasons. In this group the use of SPY Elite® changed the management of the patient in 20 cases (50%). Ten flaps were evaluated intraoperatively after anastomosis to the head and neck to ascertain adequate flow to the entire flap. In this group management was changed in two (20%). Fourteen flaps were evaluated 3–5 days post operatively due to suspected failure of a component. In five cases (36%), the use of SPY Elite® determined management with either trimming or discarding the flap. Conclusion Assessment of flap perfusion via fluorescent angiography during initial flap harvest or when flap compromise is suspected post-operatively can guide decision making in free flap reconstruction of the head and neck and can be added to existing planning and management paradigms. Level of Evidence 4 Laryngoscope, 2022 View on Web

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Effects of calcium hydroxide intracanal medicament on push‐out bond strength of endodontic sealers: A systematic review and meta‐analysis

alexandrossfakianakis shared this article with you from Inoreader Effects of calcium hydroxide intracanal medicament on push‐out bond strength of endodontic sealers: A systematic review and meta‐analysis via Journal of Esthetic and Restorative Dentistry Abstract Objective To investigate the effect of calcium hydroxide intracanal medicament on the push-out bond strength of resin-based and calcium silicate-based endodontic sealers. Methods A comprehensive search of was conducted for all relevant in-vitro studies. All randomized controlled in-vitro studies that evaluated the effect of calcium hydroxide on the push-out bond strength of resin-based or calcium silicate-based endodontic sealers were assessed. The variables of interest were extracted, and the risk of the included studies was evaluated. The standardized mean difference was calculated and the significance level was set at p value <0.05. Results A total of 26 studies were eligible for analysis. There were 45 independent comparison groups and 1009 recruited teeth. The pooled data showed no significant difference in push-out bond strength between calcium hydroxide and control group in the resin-based group (SMD = 0.03; 95% CI = −0.55, 0.60; p = 0.93), and calcium silicate-based group (SMD = 0.02; 95% CI = −0.31, 0.35; p = 0.90). Most of the studies (21 out of 26) were at medium risk of bias and five studies showed a low risk of bias. Conclusion The available evidence suggests that calcium hydroxide used as intracanal medication does not influence the push-out bond strength of the resin- and calcium silicate-based endodontic sealers. Clinical significance The results of this meta-analysis suggest that calcium hydroxide used as intracanal medication does not influence the push-out bond strength of resin-based and calcium silicate-based endodontic sealers. View on Web

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HBV REPLICATION DURING TENOFOVIR THERAPY IS FREQUENT IN HIV/HBV-COINFECTION

alexandrossfakianakis shared this article with you from Inoreader HBV REPLICATION DURING TENOFOVIR THERAPY IS FREQUENT IN HIV/HBV-COINFECTION via Clinical Infectious Diseases Advance Access ABSTRACT In the Swiss HIV Cohort Study, 61/222 (27%) HIV-suppressed persons with chronic hepatitis B virus (HBV) infection had HBV replication after two years on tenofovir, of whom 77% were suppressed thereafter. Self-reported adherence to therapy and HBV viral load at tenofovir initiation were predictors of persistent replication. View on Web

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