Displaying publications 1 - 20 of 30 in total

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  1. Mori H, Schol J, Geeraerts A, Huang IH, Jandee S, Gonlachanvit S, et al.
    J Clin Med, 2020 Oct 01;9(10).
    PMID: 33019626 DOI: 10.3390/jcm9103189
    BACKGROUND: The new coronavirus disease (COVID-19) has high infection and mortality rates, and has become a pandemic. The infection and mortality rates are lower in Asian countries than in European countries. This study aimed to conduct a survey on the effects of COVID-19 on the capacity to perform gastrointestinal motility tests in Asian countries compared with European countries.

    METHODS: We used the questionnaire previously established by our team for researchers in European countries. The correlation between the decreased rate of gastrointestinal motility and function tests, and the infection/mortality rates of COVID-19 and stringency of a government's interventions in each country was analysed and protective measures were assessed.

    RESULTS: In total, 58 gastroenterologists/motility experts in Asian countries responded to this survey. The infection/mortality rates of COVID-19 and Stringency Index had a significant impact on the testing capacity of oesophageal manometry and catheter-based pH monitoring. In European countries, most facilities used filtering facepiece 2/3 (FFP2/3) masks during oesophageal motility studies. Meanwhile, in Asian countries, most facilities used surgical masks.

    CONCLUSION: The total infection and mortality rates of COVID-19 can affect the rate of gastrointestinal motility testing and the type of protective equipment that must be used.

  2. Khairuddin S, Ngo FY, Lim WL, Aquili L, Khan NA, Fung ML, et al.
    J Clin Med, 2020 Oct 12;9(10).
    PMID: 33053848 DOI: 10.3390/jcm9103260
    Major depression contributes significantly to the global disability burden. Since the first clinical study of deep brain stimulation (DBS), over 406 patients with depression have now undergone this neuromodulation therapy, and 30 animal studies have investigated the efficacy of subgenual cingulate DBS for depression. In this review, we aim to provide a comprehensive overview of the progress of DBS of the subcallosal cingulate in humans and the medial prefrontal cortex, its rodent homolog. For preclinical animal studies, we discuss the various antidepressant-like behaviors induced by medial prefrontal cortex DBS and examine the possible mechanisms including neuroplasticity-dependent/independent cellular and molecular changes. Interestingly, the response rate of subcallosal cingulate Deep brain stimulation marks a milestone in the treatment of depression. DBS among patients with treatment-resistant depression was estimated to be approximately 54% across clinical studies. Although some studies showed its stimulation efficacy was limited, it still holds great promise as a therapy for patients with treatment-resistant depression. Overall, further research is still needed, including more credible clinical research, preclinical mechanistic studies, precise selection of patients, and customized electrical stimulation paradigms.
  3. Tang SP, Lim SC, Arkachaisri T
    J Clin Med, 2021 Feb 03;10(4).
    PMID: 33546120 DOI: 10.3390/jcm10040559
    Childhood onset systemic lupus erythematosus is a rare disease that is more common amongst Southeast Asian children compared to the West. It is typified by a peripubertal onset and a female preponderance, which increases with advancing age. Organs commonly involved at diagnosis include haematological, renal, and mucocutaneous. Fever, malar rash, and cutaneous vasculitis are common. Lupus nephritis is typically proliferative especially Class IV and contributes to both disease activity and damage. Antinuclear antibody and anti-dsDNA positivity are both prevalent in this region. Disease activity is higher than Western cohorts at onset but responds to therapy reducing to low disease activity by six months. However, organ damage occurs early and continues to accumulate over the time, a consequence of both active disease (neurological and renal systems) and steroid-related complications especially in the eye (cataract and glaucoma) and musculoskeletal systems (avascular necrosis). Infections remain the leading cause of death and mortality in this region is highly variable contributed by the heterogeneity in social economic status, healthcare access, and availability of paediatric rheumatology expertise in the region.
  4. Khandker SS, Nik Hashim NHH, Deris ZZ, Shueb RH, Islam MA
    J Clin Med, 2021 Aug 08;10(16).
    PMID: 34441789 DOI: 10.3390/jcm10163493
    Early diagnosis is still as crucial as the initial stage of the COVID-19 pandemic. As RT-PCR sometimes is not feasible in developing nations or rural areas, health professionals may use a rapid antigen test (RAT) to lessen the load of diagnosis. However, the efficacy of RAT is yet to be investigated thoroughly. Hence, we tried to evaluate the overall performance of RAT in SARS-CoV-2 diagnosis. Based on our PROSPERO registered protocol (CRD42021231432), we searched online databases (i.e., PubMed, Google Scholar, Scopus, and Web of Science) and analysed overall pooled specificity and sensitivity of RAT along with study quality, publication bias, heterogeneity and more. The overall pooled specificity and sensitivity of RAT were detected as 99.4% (95% CI: 99.1-99.8; I2 = 90%) and 68.4% (95% CI: 60.8-75.9; I2 = 98%), respectively. In subgroup analyses, nasopharyngeal specimens and symptomatic patient's samples were more sensitive in RAT, while cycle threshold (Ct) values were found to have an inverse relationship with sensitivity. In the European and American populations, RAT showed better performance. Although the sensitivity of RAT is yet to be improved, it could still be an alternative in places with poor laboratory set up. Nevertheless, the negative samples of RAT can be re-tested using RT-PCR to reduce false negative results.
  5. Seak YS, Nor J, Tuan Kamauzaman TH, Arithra A, Islam MA
    J Clin Med, 2021 Sep 02;10(17).
    PMID: 34501425 DOI: 10.3390/jcm10173978
    Due to overcrowding, personnel shortages, or problematic intravenous (IV) cannulation, acute pain management is often sub-optimal in emergency departments (EDs). The objective of this systematic review and meta-analysis was to evaluate the efficacy and safety of intranasal (IN) ketamine for adult acute pain in the emergency setting. We searched and identified studies up to 21 May 2021 via PubMed, Scopus, Web of Science, Cochrane Database, and Google Scholar. The random-effects model with 95% confidence intervals (CIs) was used to estimate mean differences (MDs) and odds ratios (ORs). The I2 statistic and Cochran's Q test were used to determine heterogeneity. The protocol was registered in PROSPERO (CRD42020213391). Seven randomised controlled trials were included with a total of 1760 patients. There was no significant difference in pain scores comparing IN ketamine with IV analgesics or placebo at 5 (MD 0.94, p = 0.26), 15 (MD 0.15, p = 0.74), 25 (MD 0.24, p = 0.62), 30 (MD -0.05, p = 0.87), and 60 (MD -0.42, p = 0.53) minutes. There was also no significant difference in the need for rescue analgesics between IN ketamine and IV analgesics (OR 1.66, 95% CI: 0.57-4.86, p = 0.35, I2 = 70%). Only mild adverse effects were observed in patients who received IN ketamine. Our results suggest that IN ketamine is non-inferior to IV analgesics and may have a role in acute pain management among adults in the ED.
  6. Tumian NR, Hunt BJ
    J Clin Med, 2022 Jan 29;11(3).
    PMID: 35160188 DOI: 10.3390/jcm11030735
    Thrombotic manifestations of antiphospholipid syndrome are often a therapeutic dilemma and challenge. Despite our increasing knowledge of this relatively new disease, many issues remain widely unknown and controversial. In this review, we summarise the latest literature and guidelines on the management of thrombotic antiphospholipid syndrome. These include the laboratory assays involved in antiphospholipid antibodies (aPL) testing, the use of direct oral anticoagulants in secondary prevention, management of recurrent thrombosis, individuals with isolated aPL, and catastrophic antiphospholipid syndrome. Treatment aims to prevent the potentially fatal and often disabling complications of APS with antithrombotic and cardiovascular risks prevention strategies. Some insights and updates on topical issues in APS are provided. We also include our current practice, which we believe is the pragmatic approach based on the currently available evidence.
  7. Qureshi M, Khan S, Bantan RAR, Daniyal M, Elgarhy M, Marzo RR, et al.
    J Clin Med, 2022 Nov 04;11(21).
    PMID: 36362783 DOI: 10.3390/jcm11216555
    BACKGROUND: Monkeypox virus is gaining attention due to its severity and spread among people. This study sheds light on the modeling and forecasting of new monkeypox cases. Knowledge about the future situation of the virus using a more accurate time series and stochastic models is required for future actions and plans to cope with the challenge.

    METHODS: We conduct a side-by-side comparison of the machine learning approach with the traditional time series model. The multilayer perceptron model (MLP), a machine learning technique, and the Box-Jenkins methodology, also known as the ARIMA model, are used for classical modeling. Both methods are applied to the Monkeypox cumulative data set and compared using different model selection criteria such as root mean square error, mean square error, mean absolute error, and mean absolute percentage error.

    RESULTS: With a root mean square error of 150.78, the monkeypox series follows the ARIMA (7,1,7) model among the other potential models. Comparatively, we use the multilayer perceptron (MLP) model, which employs the sigmoid activation function and has a different number of hidden neurons in a single hidden layer. The root mean square error of the MLP model, which uses a single input and ten hidden neurons, is 54.40, significantly lower than that of the ARIMA model. The actual confirmed cases versus estimated or fitted plots also demonstrate that the multilayer perceptron model has a better fit for the monkeypox data than the ARIMA model.

    CONCLUSIONS AND RECOMMENDATION: When it comes to predicting monkeypox, the machine learning method outperforms the traditional time series. A better match can be achieved in future studies by applying the extreme learning machine model (ELM), support vector machine (SVM), and some other methods with various activation functions. It is thus concluded that the selected data provide a real picture of the virus. If the situations remain the same, governments and other stockholders should ensure the follow-up of Standard Operating Procedures (SOPs) among the masses, as the trends will continue rising in the upcoming 10 days. However, governments should take some serious interventions to cope with the virus.

    LIMITATION: In the ARIMA models selected for forecasting, we did not incorporate the effect of covariates such as the effect of net migration of monkeypox virus patients, government interventions, etc.

  8. Chin KY, Ng BN, Rostam MKI, Muhammad Fadzil NFD, Raman V, Mohamed Yunus F, et al.
    J Clin Med, 2022 Oct 30;11(21).
    PMID: 36362662 DOI: 10.3390/jcm11216434
    Osteoporosis refers to excessive bone loss as reflected by the deterioration of bone mass and microarchitecture, which compromises bone strength. It is a complex multifactorial endocrine disease. Its pathogenesis relies on the presence of several endogenous and exogenous risk factors, which skew the physiological bone remodelling to a more catabolic process that results in net bone loss. This review aims to provide an overview of osteoporosis from its biology, epidemiology and clinical aspects (detection and pharmacological management). The review will serve as an updated reference for readers to understand the basics of osteoporosis and take action to prevent and manage this disease.
  9. Fahmy O, Fahmy UA, Alhakamy NA, Khairul-Asri MG
    J Clin Med, 2021 Dec 07;10(24).
    PMID: 34945018 DOI: 10.3390/jcm10245723
    BACKGROUND: Single-port robotic-assisted radical prostatectomy has been reported as a safe and feasible technique. However, recent studies comparing single-port versus multiple-port robotic radical prostatectomy have displayed conflicting results.

    OBJECTIVES: To investigate the benefit of single-port robotic radical prostatectomy and the impact on outcome compared to multiple-port robotic radical prostatectomy.

    METHODS: Based on PRISMA and AMSTAR criteria, a systematic review and meta-analysis were carried out. Finally, we considered the controlled studies with two cohorts (one cohort for single-port RARP and the other cohort for multiple-port RARP). For statistical analysis, Review Manager (RevMan) software version 5.4 was used. The Newcastle-Ottawa Scale was employed to assess the risk of bias.

    RESULTS: Five non-randomized controlled studies with 666 patients were included. Single-port robotic radical prostatectomy was associated with shorter hospital stays. Only 60.6% of single-port patients (109/180) required analgesia compared to 90% (224/249) of multiple-port patients (Z = 3.50; p = 0.0005; 95% CI 0.07:0.47). Opioid administration was also significantly lower in single-port patients, 26.2% (34/130) vs. 56.6% (77/136) (Z = 4.90; p < 0.00001; 95% CI 0.15:-0.44) There was no significant difference in operative time, blood loss, complication rate, positive surgical margin rate, or continence at day 90.

    CONCLUSION: The available data on single-port robotic radical prostatectomy is very limited. However, it seems comparable to the multiple-port platform in terms of short-term outcomes when performed with expert surgeons. Single-port prostatectomies might provide a shorter hospital stay and a lower requirement for opioids; however, randomized trials with long-term follow-up are mandatory for valid comparisons.

  10. Najafi P, Hadizadeh M, Cheong JPG, Mohafez H, Abdullah S, Poursadeghfard M
    J Clin Med, 2023 Feb 16;12(4).
    PMID: 36836119 DOI: 10.3390/jcm12041585
    BACKGROUND: People with multiple sclerosis (PwMS) suffer from some comorbidities, including physical and psychiatric disorders, low quality of life (QoL), hormonal dysregulation, and hypothalamic-pituitary-adrenal axis dysfunction. The current study aimed to investigate the effects of eight weeks of tele-yoga and tele-Pilates on the serum levels of prolactin and cortisol and selected physical and psychological factors.

    METHODS: Forty-five females with relapsing remitting multiple sclerosis, based on age (18-65), expanded disability status scale (0-5.5), and body mass index (20-32), were randomly assigned to tele-Pilates, tele-yoga, or control groups (n = 15). Serum blood samples and validated questionnaires were collected before and after interventions.

    RESULTS: Following online interventions, there was a significant increase in the serum levels of prolactin (p = 0.004) and a significant decrease in cortisol (p = 0.04) in the time × group interaction factors. In addition, significant improvements were observed in depression (p = 0.001), physical activity levels (p < 0.001), QoL (p ≤ 0.001), and the speed of walking (p < 0.001).

    CONCLUSION: Our findings suggest that tele-yoga and tele-Pilates training could be introduced as patient-friendly, non-pharmacological, add-on therapeutic methods for increasing prolactin and decreasing cortisol serum levels and achieving clinically relevant improvements in depression, walking speed, physical activity level, and QoL in female MS patients.

  11. Halim FC, Pesce P, De Angelis N, Benedicenti S, Menini M
    J Clin Med, 2022 Aug 28;11(17).
    PMID: 36078982 DOI: 10.3390/jcm11175052
    Background: Dental implants are widely used and in order to answer to esthetic demands, zirconia has been introduced as an abutment material as an alternative to titanium. Several studies have been published on this topic, but the results have been often inconsistent. The objective of the present study is to systematically analyze the existing literature comparing clinical outcomes of titanium and zirconia implant abutments. The study was designed as a systematic review of systematic reviews. Methods: This systematic review is in accordance with the Transparent Reporting of Systematic Reviews and Meta-analyses. A MEDLINE/PubMed, Cochrane Database of Systematic Reviews and SCOPUS literature search was performed up to and including June 2021. Data were extracted independently by two reviewers and tAMSTAR2 was used to assess the quality of the systematic reviews. Results: The electronic search identified 1146 papers, and 175 duplicates were removed. After manual screening, 954 studies were excluded and the final analysis was conducted on 11 papers. Both mechanical and esthetic outcomes and biological complications were analyzed. Conclusions: It can be concluded that titanium abutments have a better mechanical resistance than zirconia ones. Plaque accumulation is reported to be slightly higher on titanium but without any significant inflammatory process. The esthetic outcomes seem to be more related to the thickness (>3 mm) of the soft tissues than to the abutment material.
  12. Abdullah B, Pawankar R, Abdul Latiff AH, Woo KCK, Wüstenberg E, Khalid MAF, et al.
    J Clin Med, 2023 Feb 01;12(3).
    PMID: 36769797 DOI: 10.3390/jcm12031151
    Allergic rhinitis (AR) is an IgE-mediated inflammatory disease of the upper airway. AR affects the patients' quality of life, is a known risk factor for asthma and a socio-economic burden. Allergen-specific immunotherapy (AIT), comprising sublingual immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT), involves administering increasing doses of the causative allergen to induce clinical and immunologic tolerance to the allergens. It is the only currently available treatment for AR that has been proven to induce disease-modifying effects (i.e., long-term remission of allergic symptoms or potential prevention of asthma and new sensitizations). Although AIT is conventionally recommended for patients who are non-responsive to symptom-relieving pharmacotherapy, it is presently recommended as a first-line treatment for patients with moderate to severe AR who prefer a treatment with the potential for long-term remission. In light of the relatively recent implementation of AIT in Malaysia, guidelines on its appropriate indication and application are important to attain optimal outcomes. This consensus statement was developed by an expert group formed by the Malaysian Society of Allergy and Immunology to provide evidence-based recommendations for the practice of AIT in Malaysia. Patient and product selection, choice of AIT, and strategy towards an effective treatment outcome in AIT are presented.
  13. Fahmy O, Alhakamy NA, Rizg WY, Bagalagel A, Alamoudi AJ, Aldawsari HM, et al.
    J Clin Med, 2021 Oct 31;10(21).
    PMID: 34768647 DOI: 10.3390/jcm10215127
    Prostate cancer (PCa) represents the most commonly non-cutaneous diagnosed cancer in men worldwide and occupies a very wide area of preclinical and clinical research. Targeted therapy for any cancer depends on the understanding of the molecular bases and natural behaviour of the diseases. Despite the well-known effect of androgen deprivation on PCa, many patients develop resistance either for antiandrogen therapy or other new treatment modalities such as checkpoint inhibitors and chemotherapy. Comprehensive understanding of the development of PCa as well as of the mechanisms underlying its progression is mandatory to maximise the benefit of the current approved medications or to guide the future research for targeted therapy of PCa. The aim of this review was to provide updates on the most recent mechanisms regarding the development and the progression of PCa. According to the current understanding, future treatment strategies should include more predictive genetic and biomarker analysis to assign different patients to the expected most appropriate and effective treatment.
  14. De Angelis N, Signore A, Alsayed A, Hai Hock W, Solimei L, Barberis F, et al.
    J Clin Med, 2021 Oct 26;10(21).
    PMID: 34768483 DOI: 10.3390/jcm10214963
    (1) Background. Dental implant placement in the anterior region requires extreme precision due to relatively high aesthetic demand. This narrative review aimed to analyse some of the available clinical studies of the socket-shield technique and determine its viability for dental implant survival/success and complication rates. (2) Methods. An electronic search for publications was performed using the Cochrane, PubMed-MEDLINE, Web of Science, and Google Scholar databases. All electronic searches included human clinical and animal studies and were performed by three independent examiners. (3) Results. A total of 1383 records were identified with the initial search strategies, but only 25 full texts + five abstracts clinical studies were kept after the recruitment criteria screening. The technical details, advantages, and limitations of the techniques were illustrated. (4) Conclusion. Within the limitations of the present review, it would be merely justified that immediate dental implant placement in conjunction with the socket-shield technique can be a promising strategy for dental implant therapy.
  15. Ho CSH, Tan TWK, Khoe HCH, Chan YL, Tay GWN, Tang TB
    J Clin Med, 2024 Feb 21;13(5).
    PMID: 38592058 DOI: 10.3390/jcm13051222
    Background: Major depressive disorder (MDD) is a leading cause of disability worldwide. At present, however, there are no established biomarkers that have been validated for diagnosing and treating MDD. This study sought to assess the diagnostic and predictive potential of the differences in serum amino acid concentration levels between MDD patients and healthy controls (HCs), integrating them into interpretable machine learning models. Methods: In total, 70 MDD patients and 70 HCs matched in age, gender, and ethnicity were recruited for the study. Serum amino acid profiling was conducted by means of chromatography-mass spectrometry. A total of 21 metabolites were analysed, with 17 from a preset amino acid panel and the remaining 4 from a preset kynurenine panel. Logistic regression was applied to differentiate MDD patients from HCs. Results: The best-performing model utilised both feature selection and hyperparameter optimisation and yielded a moderate area under the receiver operating curve (AUC) classification value of 0.76 on the testing data. The top five metabolites identified as potential biomarkers for MDD were 3-hydroxy-kynurenine, valine, kynurenine, glutamic acid, and xanthurenic acid. Conclusions: Our study highlights the potential of using an interpretable machine learning analysis model based on amino acids to aid and increase the diagnostic accuracy of MDD in clinical practice.
  16. Rondi P, Ravanelli M, Rampinelli V, Hussain IZ, Ramanzin M, Di Meo N, et al.
    J Clin Med, 2024 Apr 29;13(9).
    PMID: 38731151 DOI: 10.3390/jcm13092624
    Background: Postoperative imaging after nasopharyngeal endoscopic resection (NER) and skull base reconstruction is quite challenging due to the complexity of the post-surgical and regional anatomy. Methods: In this retrospective observational study, we included patients treated with NER from 2009 to 2019 and submitted to Magnetic Resonance Imaging (MRI) 6 and 12 months after surgery. A radiologist with 15 years of experience analyzed all MRI scans. Results: A total of 50 patients were considered in this study, 18 of whom were excluded due to imaging unavailability, and 16 of whom were not considered due to major complications and/or persistent disease. Sixteen patients were evaluated to identify the expected findings. Inflammatory changes were observed in 16/64 subsites, and regression of these changes was observed in 8/64 at 1 year. Fibrosis was observed in 5/64 subsites and was unmodified at 1 year. The nasoseptal flap showed homogeneous enhancement at 6 months (100%) and at 1 year. The temporo-parietal fascia flap (TPFF) showed a decrease in the T2- signal intensity of the mucosal layer in 57% of the patients at 1 year and a decrease in enhancement in 43%. Conclusions: Identifying the expected findings after NER and skull base reconstruction has a pivotal role in the identification of complications and recurrence.
  17. Güngör AK, Topçu H, Aldhahi MI, Al-Mhanna SB, Gülü M
    J Clin Med, 2024 Apr 16;13(8).
    PMID: 38673569 DOI: 10.3390/jcm13082296
    Background: The modulation of cardiac sympathovagal balance alters following acute resistance training (RT) sessions. Nevertheless, the precise influence of RT at varying load intensities on this physiological response remains to be fully elucidated. Therefore, the aim of this study was to compare the time course of recovery following low- (40%), moderate- (60%), and high- (80%) load-intensity RT protocols performed up to muscle repetition failure in resistance-trained men. Method: Sixteen young, resistance-trained men (mean age: 21.6 ± 2.5 years, mean height: 175.7 ± 8.9 cm, mean weight: 77.1 ± 11.3 kg) participated in a randomized crossover experimental design involving three sessions, each taken to the point of muscle failure. These sessions were characterized by different load intensities: low (40% of 1-repetition maximum, 1RM), moderate (60% of 1RM), and high (80% of 1RM). The exercise regimen comprised four exercises-back squat (BS), bench press (BnP), barbell row (BR), and shoulder press (SP)-with each exercise consisting of three sets. Throughout each session, heart rate variability (HRV) and blood pressure (BP) parameters were assessed both pre-exercise and during a 40 min post-exercise period, segmented into 10 min intervals for stabilization. Statistical analysis involved the use of a repeated measures ANOVA. Results: It was observed that the 40% and 60% RT sessions resulted in a significantly higher root mean square of successive R-R intervals (RMSSD) value compared to the 80% RT session in the post-exercise recovery process in 30 min (respectively, p = 0.025; p = 0.028) and 40 min (respectively, p = 0.031; p = 0.046), while the 40% and 60% RT sessions produced similar responses. The 40% RT session was significantly higher in the high frequency (HF) value post-exercise in 40 min compared to the 80% RT session (p = 0.045). Conclusions: Our findings suggest that engaging in resistance training (RT) sessions to muscle failure at an intensity of 80% induces acute increases in sympathetic activity, potentially leading to elevated cardiovascular stress. For individuals with normal blood pressure, it is advisable to opt for lighter loads and higher repetition volumes when prescribing RT, as heavier-load RT may carry an increased risk of cardiac-related factors.
  18. De Angelis N, Pesce P, De Lorenzi M, Menini M
    J Clin Med, 2023 May 13;12(10).
    PMID: 37240558 DOI: 10.3390/jcm12103452
    Digital impression provides several advantages in implant prosthodontics; however, its use in full-arch rehabilitations, especially immediately after surgery, has yet to be validated. The aim of this study was to retrospectively analyse the fit of immediate full-arch prostheses, fabricated using conventional or digital impressions. Patients requiring a full-arch immediate loading rehabilitation were divided into three groups: T1 (digital impression taken immediately after surgery), T2 (Preoperative digital impression, guided surgery-prefabricated temporary bridge) and C (conventional impression taken immediately after surgery). Immediate temporary prostheses were delivered within 24 h after surgery. X-rays were obtained at the time of prosthesis delivery and at the 2-year follow-up. Primary outcomes were cumulative survival rate (CSR) and prosthesis fit. Secondary outcomes were marginal bone level (MBL) and patient satisfaction. One hundred and fifty patients were treated from 2018 to 2020, with 50 in each group. Seven implants failed during the observation period. The CSR was 99% for T1, 98% for T2 and 99.5% for C. A statistically significant difference in prosthesis fit was found among T1 and T2 vs. C. A statistically significant difference was found in the MBL between T1 and C. The outcomes of the present study suggest that digital impression is a viable alternative to conventional protocols for the realisation of full-arch immediate loading prostheses.
  19. Devassy R, Devassy RR, de Wilde MS, Krentel H, Adlan A, Torres-de la Roche LA, et al.
    J Clin Med, 2023 May 23;12(11).
    PMID: 37297823 DOI: 10.3390/jcm12113628
    Contained electromechanical morcellation has emerged as a safety approach for laparoscopic myomatous tissue retrieval. This retrospective single-center analysis evaluated the bag deployment practicability and safety of electromechanical in-bag morcellation when used for big surgical benign specimens. The main age of patients was 39.3 years (range 21 to 71); 804 myomectomies, 242 supracervical hysterectomies, 73 total hysterectomies, and 1 retroperitoneal tumor extirpation were performed. A total of 78.7% of specimens weighed more than 250 g (n = 881) and 9% more than 1000 g. The largest specimens, weighing 2933 g, 3183 g, and 4780 g, required two bags for complete morcellation. Neither difficulties nor complications related to bag manipulation were recorded. Small bag puncture was detected in two cases, but peritoneal washing cytology was free of debris. One retroperitoneal angioleiomyomatosis and three malignancies were detected in histology (leiomyosarcoma = 2; sarcoma = 1); therefore, patients underwent radical surgery. All patients were disease-free at 3 years follow-up, but one patient presented multiple abdominal metastases of the leiomyosarcoma in the third year; she refused subsequent surgery and was lost from follow-up. This large series demonstrates that laparoscopic bag morcellation is a safe and comfortable method to remove large and giant uterine tumors. Bag manipulation takes only a few minutes, and perforations rarely occur and are easy to detect intraoperatively. This technique did not result in the spread of debris during myoma surgery, potentially avoiding the additional risk of parasitic fibroma or peritoneal sarcoma.
  20. Mohd Sazlly Lim S, Sinnollareddy M, Sime FB
    J Clin Med, 2020 Sep 06;9(9).
    PMID: 32899911 DOI: 10.3390/jcm9092878
    Diabetic patients have an increased propensity to Candida sp. infections due to disease-related immunosuppression and various other physiological alterations. The incidence of candidiasis has increased in number over the years and is linked to significant morbidity and mortality in critically ill and immunosuppressed patients. Treatment of infection in diabetic patients may be complicated due to the various disease-related changes to the pharmacokinetics and pharmacodynamics (PK/PD) of a drug, including antifungal agents. Application of PK/PD principles may be a sensible option to optimise antifungal dosing regimens in this group of patients. Further studies on PK/PD of antifungals in patients with diabetes mellitus are needed as current data is limited or unavailable.
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