Comparison of periodontal open flap debridement versus closed debridement with Er,Cr:YSGG laser

Background

Traditional periodontal open flap debridement (OFD) results in reduced pocket depth (PD), clinical attachment loss (CAL), gingival recession (GR) and postoperative pain and discomfort. The quest to overcome these shortcomings has led to research into Er,Cr:YSGG laser assisted pocket therapy (ELAPT). This study was designed to compare the clinical outcomes of ELAPT versus OFD.

Methods

Fifteen patients with a PD of ≥5 mm and ≤8 mm at two sites were selected. Test sites (Group 1) were treated by ELAPT and the control (Group 2) by OFD. Clinical parameters were recorded at baseline, 3 and 6 months and included Plaque Index (PI), Gingival Index (GI), modified Sulcular Bleeding Index (mSBI), PD, CAL and GR.

Results

Both treatments produced a reduction in PI, GI, mSBI and PD, an increase in GR, and a gain in CAL at 3 and 6 months. The mean gain of CAL in Group 1 at 3 and 6 months (1.60 ± 0.78 and 1.80 ± 0.63) was similar (p > 0.05) to the value of Group 2 (1.93 ± 0.88 and 2.00 ± 0.54). GR increased significantly (p < 0.05) only in Group 2 at 3 and 6 months (1.80 ± 0.56 and 1.87 ± 0.64) compared to Group 1 (0.50 ± 0.68 and 0.60 ± 0.74).

Conclusions

ELAPT compared with OFD results in similar CAL gains with less GR and significant reductions in PD, GI and mSBI, and may be considered as an alternative to surgical therapy.     

Ultra-wide field retinal imaging: A wider clinical perspective

The peripheral retina is affected in a variety of retinal disorders. Traditional fundus cameras capture only a part of the fundus even when montaging techniques are used. Ultra-wide field imaging enables us to delve into the retinal periphery in greater detail. It not only facilitates assessing color images of the fundus, but also fluorescein angiography, indocyanine green angiography, fundus autofluorescence, and red and green free images. In this review, a literature search using the keywords “ultra-widefield imaging”, “widefield imaging”, and “peripheral retinal imaging” in English and non-English languages was done and the relevant articles were included. Ultra-wide field imaging has made new observations in the normal population as well as in eyes with retinal disorders including vascular diseases, degenerative diseases, uveitis, age-related macular degeneration, retinal and choroidal tumors and hereditary retinal dystrophies. This review aims to describe the utility of ultra-wide field imaging in various retinal disorders.     

Magnetic ion oxidation state dependent magnetoelectric coupling strength in Fe doped BCT ceramics

Polycrystalline samples of Ba_0.96Ca_0.04Ti_0.91Fe_0.09O₃ were prepared using a conventional solid state reaction route with different Fe starting precursors (Fe₂O₃, Fe₃O₄). The Rietveld refined XRD data confirmed the phase purity and tetragonal crystal structure of both the samples. The average grain size measured using SEM was ≈0.40 μm in both the samples. XPS analysis confirmed the presence of only Fe²⁺ and both Fe²⁺/Fe³⁺ in Fe₂O₃ and Fe₃O₄ doped BCT samples. The P_r and M_r values have been measured to be 1.34 μC cm⁻², 2.88 μC cm⁻² and 0.0015 emu g⁻¹ and 0.135 emu g⁻¹ in Fe₂O₃ and Fe₃O₄ doped BCT samples, respectively. The Fe₃O₄ doped samples exhibit much better M-E coupling (≈22%) as compared to Fe₂O₃ (≈7%) doped BCT samples. The results obtained hence suggest that Fe₃O₄ doping in BCT is better suited for multiferroic applications.

Polycrystalline samples of Ba_0.96Ca_0.04Ti_0.91Fe_0.09O₃ were prepared using a conventional solid state reaction route with different Fe starting precursors (Fe₂O₃, Fe₃O₄). A significant difference in the magnetic and ferroelectric properties was observed.     

Comparative evaluation of surgical outcome after removal of impacted mandibular third molars using a Piezotome or a conventional handpiece: a prospective study

Our aim was to compare the use of a conventional rotary handpiece and a Piezosurgical unit for extraction of lower third molars. We studied 40 patients, who were allocated alternately to have the third molar removed with either the handpiece or the Piezosurgical unit. Pain, trismus, and oedema were evaluated at baseline and then postoperatively, together with paraesthesiae, on postoperative days 1, 3, 5, 7, and 15. Damage to surrounding tissue was checked on the same day whereas dry socket was evaluated from postoperative day 3 onwards. More patients complained of pain in the conventional group, they also required more analgesics, and they developed trismus more often than in the Piezosurgery group. There was also significantly more postoperative swelling in the conventional group. Patients were also evaluated using the subjective Postoperative Symptom Severity (PoSSe) scale. Our results suggest that apart from some inherent limitations with the Piezotome, it is a valuable alternative for extraction of third molars.     

Renal Hemodynamics in AKI: In Search of New Treatment Targets

Novel therapeutic interventions are required to prevent or treat AKI. To expedite progress in this regard, a consensus conference held by the Acute Dialysis Quality Initiative was convened in April of 2014 to develop recommendations for research priorities and future directions. Here, we highlight the concepts related to renal hemodynamics in AKI that are likely to reveal new treatment targets on investigation. Overall, we must better understand the interactions between systemic, total renal, and glomerular hemodynamics, including the role of tubuloglomerular feedback. Furthermore, the net consequences of therapeutic maneuvers aimed at restoring glomerular filtration need to be examined in relation to the nature, magnitude, and duration of the insult. Additionally, microvascular blood flow heterogeneity in AKI is now recognized as a common occurrence; timely interventions to preserve the renal microcirculatory flow may interrupt the downward spiral of injury toward progressive kidney failure and should, therefore, be investigated. Finally, development of techniques that permit an integrative physiologic approach, including direct visualization of renal microvasculature and measurement of oxygen kinetics and mitochondrial function in intact tissue in all nephron segments, may provide new insights into how the kidney responds to various injurious stimuli and allow evaluation of new therapeutic strategies.     

Experiential avoidance as a functional dimensional approach to psychopathology: an empirical review

The construct of experiential avoidance has become more frequently used by clinical researchers. Experiential avoidance involves the unwillingness to remain in contact with private experiences such as painful thoughts and emotions and is often proposed to be critical to the development and maintenance of psychopathology. This review summarizes the empirical studies on experiential avoidance as a factor in the etiology of maladaptive behavior and its relationship to specific diagnostic categories. Although some of the current literature suggests that experiential avoidance may be implicated in various forms of psychopathology, a fundamental limitation of this research is the lack of theoretical integration and refinement with regard to operationalizing and assessing experiential avoidance. Future studies should attempt to understand the core processes involved in experiential avoidance better, and then clearly operationalize the construct and determine its incremental validity relative to other constructs.     

The effect of smoking on survival in lung carcinoma patients with brain metastasis: a systematic review and meta-analysis

The effects of smoking on survival in BM patients have yet to be reviewed and meta-analysed. However, previous studies have shown that smokers had a greater risk of dying from lung cancer compared to non-smokers. This meta-analysis, therefore, aimed to analyse the effects of cigarette smoking on overall survival (OS) and progression-free survival (PFS) in lung cancer BM patients. PubMed, Embase, Web of Science, Cochrane and Google Scholar were searched for comparative studies regarding the effects of smoking on incidence and survival in brain metastases patients up to December 2020. Three independent reviewers extracted overall survival (OS) and progression-free survival data (PFS). Random-effects models were used to pool multivariate-adjusted hazard ratios (HR). Out of 1890 studies, fifteen studies with a total of 2915 patients met our inclusion criteria. Amongst lung carcinoma BM patients, those who were smokers (ever or yes) had a worse overall survival (HR: 1.34, 95% CI 1.13, 1.60, I2: 72.1%, p-heterogeneity?<?0.001) than those who were non-smokers (never or no). A subgroup analysis showed the association to remain significant in the ever/never subgroup (HR: 1.34, 95% CI 1.11, 1.63) but not in the yes/no smoking subgroup (HR: 1.30, 95% CI 0.44, 3.88). This difference between the two subgroups was not statistically significant (p?=?0.91). Amongst lung carcinoma BM patients, smoking was associated with a worse OS and PFS. Future studies examining BMs should report survival data stratified by uniform smoking status definitions.