Medicina-Lithuania最新文献

{"title":"Interleukin-6 and Leukocyte Cell Population Data in Newly Diagnosed Sepsis-A Prospective Study.","authors":"Sara Šundalić, Iva Košuta, Ivana Baršić Lapić, Ivana Rako, Dunja Rogić, Radovan Radonić, Ana Vujaklija Brajković","doi":"10.3390/medicina61030468","DOIUrl":"10.3390/medicina61030468","url":null,"abstract":"<p><p><i>Background and Objectives:</i> Sepsis still represents a syndrome with a high mortality. A timely sepsis diagnosis and an early intervention are crucial for the disease outcomes. Sepsis-associated acute kidney injury (SA-AKI) is highly prevalent but often diagnosed late. We aimed to investigate whether serum interleukin-6 (IL-6) and leukocyte cell population data (CPD) could be adequate biomarkers for the prediction of survival and SA-AKI development. <i>Materials and Methods:</i> We conducted a prospective observational study in a medical intensive care unit of a tertiary hospital centre in Zagreb, Croatia from June 2020 to October 2023. Adult patients with newly diagnosed sepsis were included and classified as immunocompetent or immunocompromised. Blood samples were collected upon admission. <i>Results:</i> A total of 150 patients were included in the study. Ninety-six (64%) patients were immunocompetent and fifty-four (36%) were immunocompromised. The median SOFA score was 8 (6-11). SA-AKI was diagnosed in 108 (72%) patients. ICU and hospital mortality was 27.3% and 37.3%, with no significant difference between groups. Significantly higher serum IL-6 levels were noted in the immunocompromised group, while neutrophil granularity intensity was higher in the immunocompetent group. According to logistic regression analyses, elevated IL-6 levels predicted a lethal ICU outcome, while elevated IL-6 levels and neutrophil reactivity intensity were predictors of SA-AKI development. A cluster analysis revealed two patient groups with different IL-6 concentrations, and further studies indicated that the group with higher IL-6 values had significantly higher SA-AKI occurrence and increased lethal outcomes. <i>Conclusions:</i> An early serum IL-6 measurement regardless of the patients' immune status indicates disease severity. Its measurement in the early phase of disease presentation, potentially in the emergency department, might facilitate ICU admission. Further research is warranted in the field of leukocyte CDP application.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Single-Cone Obturation Using Different Sizes of Matching Gutta-Percha Points of Two Reciprocating Single-File Systems in Curved and Straight Root Canals.","authors":"Shakiba Arvaneh, René Schwesig, Shahpar Haghighat, Christian Ralf Gernhardt","doi":"10.3390/medicina61030465","DOIUrl":"10.3390/medicina61030465","url":null,"abstract":"<p><p><i>Background and Objectives:</i> Endodontic success depends on eliminating infection and creating a durable seal to prevent recontamination. The goal of this study was to assess the impact of different ISO sizes on the obturation quality using two reciprocating single-file systems, WaveOne^® Gold and Procodile^®, in two different canal morphologies. <i>Material and Methods:</i> Overall, 140 root canals from human permanent teeth were randomly assigned to 14 groups based on selected ISO sizes and straight and curved canal curvatures, and the two file systems, WaveOne^® Gold files in ISO sizes 20, 25, and 45, and Procodile^® files in ISO sizes 20, 25, 40, and 45, were employed for canal preparation. These 140 canals were obturated using corresponding gutta-percha points and AH-Plus sealer and the quality of the obturation was assessed after sectioning the roots (apical, middle, coronal third) by evaluating the resulting 420 sections under a digital fluorescence microscope with regard to the proportion of gutta-percha, sealer, and unfilled areas. The results were analyzed using nonparametric tests. <i>Results:</i> For both systems, there was a significant difference in the percentage of gutta-percha-filled areas (PGFA, <i>p</i> < 0.001) and sealer-filled areas (PSFA, <i>p</i> < 0.001 among the different ISO sizes). However, no significant difference was observed in the percentage of unfilled areas (PUA, <i>p</i> = 0.354). ISO 40 demonstrated the best results, with the highest percentage of gutta-percha-filled areas (87%) and the lowest percentages of sealer-filled areas (13%) and voids (0.5%). In contrast, the lowest percentages of gutta-percha filled areas were observed in root canal fillings with ISO 20 (81%) and ISO 25 (81%). Regarding both reciprocating file system sizes, ISO 45 in WaveOne^® Gold and ISO 40 in Procodile^® demonstrated significantly improved (<i>p</i> < 0.05) filling quality, with PGFA of 85% and 87%, respectively. The differences between both systems were not significant. <i>Conclusions:</i> The results presented suggest that larger sizes provide better filling results, especially in the apical region. These results underline the importance of selecting appropriate preparation sizes adjusted to the initial anatomical specifications to optimize root canal obturation and ensure a high quality and durable seal.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Sectional and Longitudinal Associations Among Weight Stigma, Psychological Distress, and Eating Behaviors in Youth with Obesity: A Clinical Sample.","authors":"Wee Shen Khoo, Ying-Chu Chen, Yen-Yin Chou, Yu-Wen Pan, Yun-Han Weng, Meng-Che Tsai","doi":"10.3390/medicina61030466","DOIUrl":"10.3390/medicina61030466","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Obesity in youth is a growing public health concern, placing them at higher risk for adverse physical and psychological outcomes. Understanding the predictors that affect weight management, particularly the role of internalized weight stigma, psychosocial factors, and eating behaviors, is essential for developing an effective intervention at longitudinal follow-up. <i>Materials and Methods</i>: We enrolled 102 youths with obesity aged 10 to 18 years old from clinical settings. Baseline demographic data, psychosocial measures, including the Weight Self-Stigma Questionnaire (WSSQ) and Hospital Anxiety and Depression Scale (HADS), and eating behavior scales, such as the Three-Factor Eating Questionnaire (TFEQ-R21) and eating disorder as Sick, Control, One, Fat, Food questionnaire (SCOFF), were collected in the first visit. We conducted a study with both cross-sectional and longitudinal components. Correlational bivariate analysis was conducted to explore relationships between key variables. The factors affecting BMI changes were investigated using generalized estimating equations (GEEs) as part of a longitudinal analysis. <i>Results</i>: The mean age of participants was 13.22 years and 63.7% were male. Bivariate correlation analysis revealed positive relationships between initial BMI Z-scores and WSSQ scores (r = 0.196, <i>p</i> < 0.05). In bivariate analysis, a negative correlation was found between the difference in BMI Z-scores and visit number (r = -0.428, <i>p</i> < 0.01). GEE analysis demonstrated that initial BMI Z-scores (coefficient = 1.342, <i>p</i> < 0.001) and anxiety (coefficient = 0.050, <i>p</i> < 0.001) were significant positive predictors of BMI Z-scores, while depression was negatively associated (coefficient = -0.081, <i>p</i> < 0.001). Excluding the TFEQ subscales, SCOFF improved the model's QIC and highlighted WSSQ as a significant, albeit weak, predictor (<i>p</i> = 0.615 in the full model versus <i>p</i> < 0.05 in the reduced model). <i>Conclusions</i>: Psychosocial factors, particularly anxiety and weight stigma, are associated with elevated BMI Z-scores in youth affected by obesity in this study. The baseline age, BMI Z-score, internalized weight stigma, and psychological stress influenced the body weight trajectory over time. Frequent clinical follow-ups contribute to improved BMI outcomes. Future research may examine the efficacy of weight management by reducing weight stigma and psychological distress along with the outpatient care of obesity.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Application of Machine Learning Models to Predict Stillbirths.","authors":"Oguzhan Gunenc, Sukran Dogru, Fikriye Karanfil Yaman, Huriye Ezveci, Ulfet Sena Metin, Ali Acar","doi":"10.3390/medicina61030472","DOIUrl":"10.3390/medicina61030472","url":null,"abstract":"<p><p><i>Background and Objectives</i>: This study aims to evaluate the predictive value of comprehensive data obtained in obstetric clinics for the detection of stillbirth and the predictive ability set of machine learning models for stillbirth. <i>Material and Method</i>: The study retrospectively included all stillbirths followed up at a hospital between January 2015 and March 2024 and randomly selected pregnancies that resulted in a live birth. The electronic record system accessed pregnant women's maternal, fetal, and obstetric characteristics. Based on the perinatal characteristics of the cases, four distinct machine learning classifiers were developed: logistic regression (LR), Support Vector Machine (SVM), Random Forest (RF), and multilayer perceptron (MLP). <i>Results</i>: The study included a total of 951 patients, 499 of whom had live births and 452 of whom had stillbirths. The consanguinity rate, fetal anomalies, history of previous stillbirth, maternal thrombosis, oligohydramnios, and abruption of the placenta were significantly higher in the stillbirth group (<i>p</i> = 0.001). Previous stillbirth histories resulted in a higher rate of stillbirth (OR: 7.31, 95%CI: 2.76-19.31, <i>p</i> = 0.001). Previous thrombosis histories resulted in a higher rate of stillbirth (OR: 14.13, 95%CI: 5.08-39.31, <i>p</i> = 0.001). According to the accuracy estimates of the machine learning models, RF is the most successful model with 96.8% accuracy, 96.3% sensitivity, and 97.2% specificity. <i>Conclusions</i>: The RF machine learning approach employed to predict stillbirths had an accuracy rate of 96.8%. We believe that the elevated success rate of stillbirth prediction using maternal, neonatal, and obstetric risk factors will assist healthcare providers in reducing stillbirth rates through prenatal care interventions.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Effects of Chorionic Gonadotropin Alfa and Anastrozole on Sperm Retrieval Rate in Patients with Non-Mosaic Klinefelter Syndrome Following Microdissection Testicular Sperm Extraction.","authors":"Eyyup Sabri Pelit, Yavuz Onur Danacıoğlu, Bülent Katı","doi":"10.3390/medicina61030467","DOIUrl":"10.3390/medicina61030467","url":null,"abstract":"<p><p><i>Background and Objectives</i>: This study aimed to compare the effects of choriogonadotropin alfa and anastrozole treatments on the success of sperm retrieval in patients with Klinefelter syndrome (KS) undergoing micro-TESE at our clinic. <i>Materials and Methods</i>: We conducted a retrospective review of a cohort including patients with non-mosaic KS who underwent micro-TESE for fertility treatment at the Reproductive Medicine Center of our university hospital. This study included 43 patients who had not received exogenous testosterone therapy prior to or during the procedure. Before surgical sperm retrieval, all patients received either choriogonadotropin alfa or anastrozole treatment based on their preference. Micro-TESE was performed on all patients after three months of treatment. <i>Results:</i> The overall SRR in the cohort post-micro-TESE was found to be 32.6%. There was a significant increase in post-treatment testosterone levels compared to pre-treatment levels. Upon dividing patients into two groups based on whether sperm was successfully retrieved, we observed significant improvements in testosterone levels in both groups following treatment. In the group presenting with successful sperm retrieval, 28.6% of patients had received choriogonadotropin alfa, while 71.4% had received anastrozole. No statistically significant difference was found between treatment groups in terms of micro-TESE success. Both choriogonadotropin alfa and anastrozole treatments resulted in significant improvements in testosterone levels following treatment compared to pre-operative levels. Furthermore, in the choriogonadotropin alfa group, there were significant decreases in follicle-stimulating hormone and luteinizing hormone levels, as well as a significant increase in estradiol levels after treatment. Post-treatment E2 levels were significantly lower in the anastrozole group than in the choriogonadotropin alfa group (<i>p</i> = 0.032), while the mean testicular volume was statistically significantly lower in the choriogonadotropin alfa group. <i>Conclusions:</i> This study suggests that anastrozole treatment before micro-TESE in patients with KS yields more successful results in terms of the SRR compared to choriogonadotropin alfa treatment.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Initial Neutropenia and Neutrophil Dynamics in Personalizing Chemotherapy for Platinum-Resistant Ovarian Cancer.","authors":"Radu-Dumitru Dragomir, Alina-Gabriela Negru, Marina-Adriana Mercioni, Dorel Popovici, Sorin Săftescu, Andiana Roxana Blidari, Răzvan Ovidiu Curcă, Ioan Sas","doi":"10.3390/medicina61030470","DOIUrl":"10.3390/medicina61030470","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Platinum-resistant ovarian cancer (PROC) is associated with limited treatment options and poor outcomes, with median progression-free survival (PFS) and overall survival (OS) remaining suboptimal. Neutropenia, a common chemotherapy-related toxicity, has shown potential as a predictive biomarker for treatment efficacy in several malignancies, including ovarian cancer. However, its role as a prognostic marker, particularly baseline neutropenia, remains underexplored. This study aimed to evaluate the prognostic and predictive value of initial neutropenia and neutrophil dynamics in PROC patients undergoing chemotherapy. <i>Materials and Methods</i>: A retrospective cohort study was conducted on 250 PROC patients treated between 2018 and 2022 at the OncoHelp Medical Center, Timișoara, Romania. Patients were stratified into two groups based on baseline absolute neutrophil count (ANC), as those with initial neutropenia (ANC < 2000/mm³) and without initial neutropenia (ANC ≥ 2000/mm³). Clinical outcomes, including tumor response, PFS, and OS, were assessed using RECIST 1.1 criteria. Hematological toxicities and neutrophil dynamics across three chemotherapy cycles were analyzed. <i>Results</i>: Patients with baseline neutropenia demonstrated significantly higher tumor response rates (47.05% vs. 27.27%; <i>p</i> = 0.002), longer median PFS (8.2 vs. 6.3 months; <i>p</i> = 0.008), and extended median OS (14.5 vs. 11.2 months; <i>p</i> = 0.002). Hematological toxicities, including Grade ≥3 neutropenia and febrile neutropenia, were more frequent in the neutropenic group (<i>p</i> < 0.001). Baseline ANC thresholds effectively predicted clinical outcomes, with an AUC of 0.79 for OS. <i>Conclusions</i>: Baseline neutropenia is a significant prognostic marker in PROC, correlating with improved tumor response and survival outcomes despite increased hematological toxicities. These findings support incorporating baseline ANC into treatment personalization strategies for PROC.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Performance and Interobserver Agreement of the Vesical Imaging-Reporting and Data System (VI-RADS) in Bladder Cancer Staging: A Systematic Review.","authors":"Alexandru Nesiu, Dorin Novacescu, Silviu Latcu, Razvan Bardan, Alin Cumpanas, Flavia Zara, Victor Buciu, Radu Caprariu, Talida Georgiana Cut, Ademir Horia Stana","doi":"10.3390/medicina61030469","DOIUrl":"10.3390/medicina61030469","url":null,"abstract":"<p><p><i>Background and Objectives</i>: The Vesical Imaging-Reporting and Data System (VI-RADS) represents a standardized approach for interpreting multiparametric magnetic resonance imaging (mp-MRI) in bladder cancer (BC) evaluation. This systematic review aimed to assess the VI-RADS' diagnostic performance and interobserver agreement in distinguishing muscle-invasive from non-muscle-invasive BC, a crucial differentiation for treatment planning. <i>Materials and Methods</i>: A systematic literature search was conducted through PubMed, Google Scholar, and Web of Science, over an initial five-year time span, from VI-RADS' inception (May 2018) to November 2023. Studies reporting VI-RADS' diagnostic performance with histopathological confirmation and interobserver agreement data were included. The diagnostic accuracy was assessed using sensitivity and specificity, while interobserver agreement was evaluated using Cohen's κ coefficient. <i>Results</i>: Nine studies comprising 1249 participants met the inclusion criteria. Using a VI-RADS score cutoff of ≥3, the pooled sensitivity and specificity for detecting muscle invasion were 88.2% and 80.6%, respectively. Interobserver agreement showed excellent consistency with a mean κ value of 0.82. Individual study sensitivities ranged from 74.1% to 94.6%, while specificities varied from 43.9% to 96.5%. <i>Conclusions</i>: VI-RADS demonstrates high diagnostic accuracy and excellent interobserver agreement in BC staging, supporting its role as a reliable non-invasive diagnostic tool. However, it should be used as a complementary tool to, not a replacement for, histopathological confirmation. Moreover, the variability in specificity suggests the need for standardized training and interpretation protocols. Clinical correlation and adequate reader experience are essential for optimal implementation. Future integration with pathological data may further enhance its predictive value.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrostomy in Children: A 5-Year Single Tertiary Center Experience.","authors":"Iulia Florentina Ţincu, Bianca Teodora Chenescu, Gabriel Cristian Drăgan, Anca Ioana Avram, Doina Anca Pleșca","doi":"10.3390/medicina61030459","DOIUrl":"10.3390/medicina61030459","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Pediatric patients with complex medical conditions, including neurological impairments, genetic syndromes, dysphagia, and malnutrition, often face feeding difficulties that require enteral nutrition support. The optimal technique for gastrostomy tube (GT) placement in children remains unclear, with options such as laparoscopic gastrostomy and percutaneous endoscopic gastrostomy (PEG) being compared in previous studies. This study evaluates outcomes, including complications and caregiver satisfaction, associated with different GT placement techniques in pediatric patients, focusing on the impact of concomitant anti-reflux surgery (fundoplication). <i>Materials and Methods</i>: This retrospective analysis of 71 children (34 with anti-reflux surgery [Group 1], 37 without [Group 2]) undergoing GT placement between 2019 and 2024. Data included demographics, procedural details, complications, and caregiver satisfaction assessed via the Structured Satisfaction Questionnaire with Gastrostomy Feeding (SAGA-8). <i>Results:</i> A total of 71 patients (34 in Group 1, 37 in Group 2) were included in the final analysis. The mean age at the time of the procedure was 5.0 ± 1.1 years, with cerebral palsy being the most common underlying condition. Laparoscopic GT was performed in 97% of cases (69/71), with two percutaneous endoscopic gastrostomy (PEG) placements. Common complications included suppuration (32.35% Group 1 vs. 21.62% Group 2, <i>p</i> = 0.88) and infection (5.88% vs. 2.70%, <i>p</i> = 0.67). There were no significant differences between groups in terms of complication rates, although patients in Group 1 had longer hospitalization durations (7.51 ± 3.56 days vs. 4.22 ± 2.13 days, <i>p</i> < 0.005). Caregiver satisfaction, as assessed by the SAGA-8, was high, with 84.5% of families reporting positive outcomes. Factors influencing satisfaction included previous aspiration pneumonia and the use of home blenderized diets post-discharge. <i>Conclusions:</i> Both laparoscopic and PEG techniques are associated with low complication rates and high caregiver satisfaction in pediatric patients requiring gastrostomy placement. The laparoscopic approach may be preferred for patients undergoing concomitant fundoplication.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy of Remineralizing Materials on Artificial Enamel Lesions: An In Vitro Study.","authors":"Gustė Klimaitė, Arūnas Vasiliauskas, Pranas Grinkevičius, Dominyka Grinkevičienė, Deivydas Šapalas","doi":"10.3390/medicina61030462","DOIUrl":"10.3390/medicina61030462","url":null,"abstract":"<p><p><i>Background and Objectives:</i> Contemporary caries treatment seeks to preserve hard dental tissues as well as to promote lesion remineralization and biological tissue regeneration. While fluoride-based treatments remain the gold standard, their effectiveness has limitations, prompting interest in innovative remineralization technologies. Nano-hydroxyapatite (nano-HA) varnish and self-assembling peptide (SAP) P11-4 are promising biomimetic materials that promote enamel repair, yet long-term data on their efficacy are limited. The objectives of this study were to evaluate the effectiveness of nano-HA varnish and peptide P11-4 in restoring enamel surface hardness after artificial lesions in vitro and to compare them to a control group and fluoride varnish. <i>Materials and Methods:</i> Artificial enamel lesions were created on the buccal surfaces of 36 extracted human molars, which were randomly divided into four groups (<i>n</i> = 9): control, peptide P11-4, fluoride varnish, and nano-hydroxyapatite varnish. After applying the materials as per manufacturer instructions, specimens were stored in artificial saliva for 14 days. Enamel surface hardness was measured using the Vickers hardness test (HV) at baseline, after demineralization, and after remineralization. Statistical analysis was performed with \"IBM SPSS 27.0\" using non-parametric Kolmogorov-Smirnov, Kruskal-Wallis, Dunn's, and Wilcoxon tests. <i>Results:</i> The mean baseline enamel hardness value was 323.95 (SD 33.47) HV. After 14 days of demineralization, the mean surface hardness of artificial enamel lesions significantly plummeted to 172.17 (SD 35.96) HV (<i>p</i> = 0.000). After 14 days of remineralization, the mean value significantly increased to 213.21 (SD 50.58) HV (<i>p</i> = 0.001). The results of the study revealed statistically significant enamel remineralization of the peptide P11-4 group in regard to the demineralized enamel (<i>p</i> < 0.05). In contrast, there were no significant results in other treatment groups (<i>p</i> > 0.05). Remineralization of enamel was the highest in samples from the P11-4 group (54.1%), followed by the nano-HA group (35.4%), FV group (17.8%), and control group (11.2%). There was a significant difference (<i>p</i> < 0.05) in the remineralizing ability between the peptide P11-4 and all other treatment groups. <i>Conclusions:</i> Self-assembling peptide P11-4 effectively remineralized artificial enamel lesions and proved to be significantly more effective compared to fluoride varnish and nano-hydroxyapatite varnish, showcasing its superior performance as a remineralizing agent.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Clinical Role of SIRT-3 in the Acute Rejection Process of Kidney Transplantation and Its Effects on Graft Outcomes: Evaluation of Biomarker Potential.","authors":"Necip Altundaş, Eda Balkan, Murat Kizilkaya, Murat Altunok, Elif Demirci, Nurhak Aksungur, Salih Kara, Gürkan Öztürk, Abdullah Uyanik","doi":"10.3390/medicina61030457","DOIUrl":"10.3390/medicina61030457","url":null,"abstract":"<p><p><i>Background and Objectives</i>: The aim of this study was to investigate the changes in the SIRT family, the effects of sirtuins on kidney graft function, and their potential as biomarkers in patients who develop rejection after kidney transplantation. <i>Materials and Methods</i>: Blood samples were collected from 45 kidney transplant patients before and after rejection. Some of these patients experienced T-cell-mediated early rejection (TCMR), while others presented antibody-mediated late rejection (ABMR). The mRNA expression levels of SIRT-1, SIRT-3, and SIRT-7 were measured via real-time PCR, while the protein levels of SIRT-1, SIRT-2, SIRT-3, SIRT-5, and SIRT-7 were assessed using ELISA. Patients were grouped based on rejection type and histological characteristics. Statistical analyses were performed using SPSS software (V23). <i>Results</i>: The mean age of the patient group was 42.22, while the control group had a mean age of 35.23 (<i>p</i> = 0.002). SIRT-1, SIRT-3, and SIRT-7 levels were significantly higher in patients with rejection (<i>p</i> < 0.001). In patients with late-stage rejection, SIRT-3 was found to be associated with interstitial fibrosis and C4d accumulation. SIRT-7 levels showed a weak correlation with potassium levels (<i>p</i> = 0.014). <i>Conclusions</i>: Our findings demonstrate significant changes in the SIRT family during both early- and late-stage rejection processes. Particularly, the role of SIRT-3 in the late stage is highlighted, suggesting the potential use of this gene as a biomarker for managing rejection processes. These findings could provide valuable insights for developing treatment strategies in organ transplantation.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}