Bioactivity analysis of bioceramic sealers and repair cements on the phenotype and cytokine secretion profile of CD14+ monocytes: An ex‐vivo study

alexandrossfakianakis shared this article with you from Inoreader Bioactivity analysis of bioceramic sealers and repair cements on the phenotype and cytokine secretion profile of CD14+ monocytes: An ex‐vivo study via International Endodontic Journal Abstract Aim This study evaluated the immune bioactivity of testing media (TM) obtained from different calcium silicate-based sealers and cements on monocyte morphology, activation, differentiation, and cytokine secretion. Methods Blood-derived CD14+ monocytes were isolated and cultured for 5 days with 25% TM from the following calcium silicate-based materials: TotalFill BC RRM Fast-Set Putty, Biodentine, TotalFill BC Sealer, and BioRoot-RCS. A resin-based endodontic cement was used as a control. The expression of surface markers such as CD86, HLA-DR, CD16, CD309, and CD209, and cytokine secretion were analysed by flow cytometry. Data were analysed using the one-way repeated measures (RM) analysis of variance (ANOVA) multiple comparison test and a Holm-Sidak multiple comparison post-hoc test (p<0.05). Results This comparative analysis revealed that monocytes co-cultured with calcium silicate-based materials showed a spindle-shaped morphology compared to the round shape observed in the control. Regarding activation markers, BioRoot-RCS and Biodentine significantly increased CD86 expression compared with the control sample, whereas no significant differences (p>0.05) were observed in HLA-DR expression. In addition, no differences were observed among the differentiation markers. When the inflammatory cytokines were analysed, BioRoot-RCS increased the secretion of IL-1β, IL-6, IL-10, and TNF-α, whereas BioRoot-RCS and Biodentine significantly decreased IL-8 production (p<0.05). Conclusions These data showed that the calcium silicate-based materials tested changed the morphology of CD14+ monocytes; however, only BioRoot-RCS and Biodentine significantly upregulated CD86. In addition, BioRoot-RCS was the sealer with the highest immunomodulatory properties for cytokine production which means that it can contribute with the in vivo healing process and regeneration of periapical lesions. View on Web

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High titers of neutralizing antibodies in the blood fail to eliminate SARS‐CoV‐2 viral RNA in the upper respiratory tract

alexandrossfakianakis shared this article with you from Inoreader High titers of neutralizing antibodies in the blood fail to eliminate SARS‐CoV‐2 viral RNA in the upper respiratory tract via Journal of Medical Virology Abstract Retest positive SARS-CoV-2 viral RNA, as a unique phenomenon among the discharged individuals, has been demonstrated to be safe in the community. Still, the underlying mechanism of viral lingering is less investigated. In this study, first, we find that the frequency of viral RNA positive retest differs among variants. Higher ratios of viral RNA positive retest were more frequently observed among Delta (61.41%, 514 of 837 cases) and Omicrons (39.53%, 119 of 301 cases) infection than ancestral viral infection (7.27%, 21 of 289 cases). Second, the tissues where viral RNA reoccurred were altered. Delta RNA reoccurred mainly in the upper respiratory tract (90%), but ancestral virus RNA mainly in the gastrointestinal tract (71%). Third, vaccination did not reduce the frequency of viral RNA-positive retests, despite high concentrations of viral-specific antibodies in the blood. Finally, 37 of 55 (67.27%) Delta-infected patients receiving neutralizing antibody (nAb ) therapy become viral RNA retest positive when high concentrations of neutralizing antibodies still patrol in the blood. Altogether, our findings suggest that the presentence of high titers of neutralizing antibodies in the blood is incompetent in clearing residual viral RNA in the upper respiratory tract. This article is protected by copyright. All rights reserved. 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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InCISE: Instrument for Comprehensive Incisional and Surgical Evaluation

alexandrossfakianakis shared this article with you from Inoreader InCISE: Instrument for Comprehensive Incisional and Surgical Evaluation via The Laryngoscope The evaluation of healing after head and neck surgery is currently qualitative and non-standardized. We developed InCISE: Instrument for comprehensive incisional and surgical evaluation to assess surgical wounds, which was found to be reliable, reproducible, and consistent. Objective The evaluation of healing after head and neck surgery is currently qualitative and non-standardized, limiting the quality of surgical healing assessments in clinical and research settings. We sought to develop an objective, standardized wound assessment score, and hypothesize that a reliable instrument can be developed to evaluate head and neck surgical wounds. Methods A prospective cohort study was conducted in a tertiary-care, academic head and neck surgery practice. Patients undergoing head and neck surgery were enrolled. A digital photograph protocol was developed for evaluating healing surgical wounds. A panel of experts developed and refined a wound healing score and established reliability, reproducibility, internal consistency, and validity of the score. Results InCISE: Instrument for comprehensive incisional and surgical evaluation was created. The utility of our wound healing score was assessed using classical test theory. We performed the major steps of establishing reliability in head and neck surgeons: (1) internal consistency (Cronbach's α = 0.81), (2) inter-observer reliability (intra-class correlation = 0.76), and (3) intra-rater reliability (intra-class correlation = 0.87), and content validity (through focus groups). Our composite measure was found to have strong internal consistency, inter-rater reliability, and intra-rater reliability. Preliminary work suggests criterion validity via associations with physical health related quality of life (SF-12). Conclusion A wound healing score for head and neck surgery, InCISE, has been developed and is reliable, reproducible, and consistent. Although content validity is present and criterion validity is suggested, work continues to establish validity in this instrument to allow for expanded clinical and research use. Level of Evidence N/A Laryngoscope, 2022 View on Web

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USP36 promotes tumorigenesis and drug sensitivity of glioblastoma by deubiquitinating and stabilizing ALKBH5

alexandrossfakianakis shared this article with you from Inoreader USP36 promotes tumorigenesis and drug sensitivity of glioblastoma by deubiquitinating and stabilizing ALKBH5 via Neuro-Oncology Advance Access Abstract Background ALKBH5 is aberrantly activated and exerts critical roles in facilitating the development of glioblastoma. However, the underlying activation mechanism by which ALKBH5 protein is increased in glioblastoma is not completely understood. Our study aimed to elucidate the signaling pathways involved in mediating ALKBH5 protein stability. Methods The contribution of deubiquitinating enzymes (DUB) to the fluctuation of ALKBH5 protein expression were globally profiled with western blot analysis. Mass spectrometry and immunoprecipitation were performed to identify the USP36 and ALKBH5 interaction. The effects of USP36 on the stability of ALKBH5 were detected with in vivo and in vitro ubiquitination assays. Cell proliferation assays, neurosphere formation, limited dilution assay, and intracranial tumor growth assays were implemented to assess the co llaborative capacities of USP36 and ALKBH5 in tumorigenesis. Results Ubiquitin-specific peptidase 36 (USP36), as a potential ALKBH5-activating DUB, played an essential role in stabilization of ALKBH5 and regulation of ALKBH5 mediated gene expression in glioblastoma. The depletion of USP36 drastically impaired cell proliferation, deteriorated the self-renewal of GSCs and sensitized GSCs to temozolomide (TMZ) treatment. Furthermore, the deletion of USP36 substantially decreased the in vivo tumor growth when monitored by bioluminescence imaging. Our findings indicate that USP36 regulates the protein degradation and expression of ALKBH5, and the USP36-ALKBH5 axis orchestrates glioma tumorigenesis. Conclusion Our findings identify USP36 as a DUB of ALKBH5 and its role in glioblastoma progression, which may serve as a potential therapeutic target for glioblastoma treatment. 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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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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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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Maxillary vertical alveolar ridge augmentation using sandwich osteotomy technique with simultaneous versus delayed implant placement: A proof of principle randomized clinical trial

alexandrossfakianakis shared this article with you from Inoreader Maxillary vertical alveolar ridge augmentation using sandwich osteotomy technique with simultaneous versus delayed implant placement: A proof of principle randomized clinical trial via Clinical Implant Dentistry and Related Research Abstract Background The sandwich osteotomy technique usually requires high surgical skills and prolonged intraoperative time and had some technical drawbacks with a subsequent deficient amount of vertical bone gain. The aim of this study was to evaluate the final vertical bone gain using sandwich osteotomy with simultaneous versus delayed implant placement in the anterior maxilla. Material and methods This study included 16 patients having multiple missing maxillary anterior teeth with a vertically deficient alveolar ridge. Patients were randomly assigned into two equal groups. Both groups were treated using sandwich osteotomy with interpositional particulate bovine bone graft. In the study group (8 patients, 17 implants), the transport mobilized bone segment was fixed in position using simultaneous implant placement. Whereas in the control group (8 patients, 18 implants), micro-plates and screws were used, followed by a second-stage surgery for plates removal and delayed implant placement. Radiographic assessment included 4 months postoperative mean of vertical gain in alveolar ridge height, taken from cross-sectional cuts of cone beam CT. Results The mean vertical bone gain in the study group was 4.04 ± 0.59 mm compared to 3.86 ± 0.52 mm in the control group with no statistically significant difference (p = 0.518). The mean value of bone gain percentage in the study group was 33.02% compared to 31.75% in the control group, with no statistically significant difference (p = 0.656). Conclusion The sandwich osteotomy technique with simultaneous implant placement is a reliable method for vertical ridge augmentation that eliminates the need for a secondary surgery. View on Web

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