Forensic determination of dental age by cementum thickness of human teeth

AimThe purpose of this study was to assess the correlation between the known chronological age and the dental cementum thickness (DCT) in male and female subjects in different age groups.Material and methodsThe study sample consisted of 57 donor teeth of both sexes. Teeth were classified by donors’ sex and divided into three age groups: 10-19, 30-39 and 60-69 years. Tooth roots were cut with transverse ground sections in the apical, middle, and cervical thirds. DCT measurements were made on photomicrographs of light microscope. The correlation between DCT and the chronological age was calculated using the Spearman correlation coefficient.ResultsA positive correlation was found (r=0.47, p <0.001) between DCT and age of the donor. DCT decreased from apical to cervical ground section (median [IQR] apical section 216.72 [128.25-375.00] μm, middle section 158.44 [87.66-284.90] μm; cervical section 96.60 [70.05-165.59] µm). DCT variability was influenced by sex, number of tooth roots and the condition of the tooth crown. The influence differed depending on the location of the section, being most prominent cervically.ConclusionThe present study showed correlation of DCT with age, with significant influence of sex, number of tooth roots, condition of the tooth crown and location of the root section.     

Forensic dental identification in complicated fractured skull conditions: case report with adapted algorithm for image comparison

ObjectiveTo analyze the perspective of using an adapted algorithm for digital images comparison while providing forensic dental identification in complicated fractured skull conditions by ante-mortem and post-mortem radiographical data sets.Materials and MethodsAnte-mortem orthopantomogram and post-mortem peri-apical X-ray images were converted in *.jpeg format with their further import into GIMP 2.10 software (The GIMP Development Team). Segmentation of OPG-image was provided in topographical projections of jaw segments obtained directly from the victim. Comparison of analyzed image segments was provided manually within GIMP 2.10 software using functions of “Layers” and “Opacity” through the proposed algorithm.ResultsConsidering the fact that 20 positive concordant dental identifiers overall were verified during comparison of AM and PM X-ray datasets, we can conclude that odontological identity was established. All above-mentioned discrepancies could be classified as explainable. Inter-agreement rate between two investigators considering correspondence between AM and PM datasets reached Cohen’s kappa level which is equal to 0,97, while positive 100% agreement was reached considering 21 out of 24 analyzed characteristics.ConclusionAvailable AM and PM radiographical datasets represent a sufficient information for effective forensic dental identification, even if such were obtained by different roentgenological techniques (orthopantomography and periapical radiography). Using of an adapted algorithm for digital images comparison with forensic dental purposes could potentially overcome cognitive bias and observer’s effect, speed up the process of analysis and increase the accuracy and inter-agreement rate while referencing AM and PM datasets.     

Antifibrotic activity of Taraxacum officinale root in carbon tetrachloride-induced liver damage in mice

Aim of the study

Dandelion (Taraxacum officinale) has been traditionally used in the treatment of various liver disorders. The present study was aimed to assess the efficacy of dandelion root water–ethanol extract (DWE) in carbon tetrachloride (CCl₄)-induced hepatic fibrosis.

Materials and Methods

The mice were treated with CCl₄ dissolved in olive oil (20%, v/v, 2 ml/kg) intraperitoneally (i.p.), twice a week for 4 weeks. DWE was administered i.p. once daily for next 10 days, in doses of 200 and 600 mg/kg of body weight. The degree of hepatic fibrosis was determined by hydroxyproline content and Mallory trichrome staining. Oxidative stress was determined by measuring hepatic superoxide dismutase (Cu/Zn SOD) activity. The expression and specific tissue distribution of glial fibrillary acidic protein (GFAP), alpha-smooth muscle actin (α-SMA), and metallothionein (MT) I/II in the liver were determined by immunohistochemistry.

Results

Hepatic Cu/Zn SOD activity has been decreased in intoxicated mice and normalized in DWE treated groups. MT I/II immunopositivity was strongly reduced in the CCl₄ group. DWE treatment successfully decreased hepatic fibrinous deposits, restored histological architecture, and modulate the expression of GFAP and α-SMA. Concomitantly, MT I/II expression increased in the DWE treated groups.

Conclusions

Our results suggest the therapeutic effect of DWE on CCl₄-induced liver fibrosis by the inactivation of hepatic stellate cells and the enhancement of hepatic regenerative capabilities. The present results provide scientific evidence to substantiate the traditional use of Taraxacum officinale root in hepatic disorders.     

Epidemiological characteristics,baseline clinical features,and outcomes of critically ill patients treated in a coronavirus disease 2019 tertiary center in continental Croatia

AimTo describe epidemiological characteristics and baseline clinical features, laboratory findings at intensive care unit (ICU) admission, and survival rates of critically ill coronavirus disease 2019 (COVID-19) patients treated at a tertiary institution specialized for COVID-19 patients.MethodsThis retrospective study recruited 692 patients (67.1% men). Baseline demographic data, major comorbidities, anthropometric measurements, clinical features, and laboratory findings at admission were compared between survivors and non-survivors.ResultsThe median age was 72 (64-78) years. The median body mass index was 29.1 kg/m². The most relevant comorbidities were diabetes mellitus (32.6%), arterial hypertension (71.2%), congestive heart failure (19.1%), chronic kidney disease (12.6%), and hematological disorders (10.3%). The median number of comorbidities was 3 and median Charlson Comorbidity Index (CCI) was 5. A total of 61.8% patients received high-flow nasal oxygen therapy (HFNO) and 80.5% received mechanical ventilation (MV). Median duration of HFNO was 3, and that of MV was 7 days. ICU mortality rate was 72.7%. Survivors had significantly lower age, number of comorbidities, CCI, sequential organ failure assessment score, serum ferritin, C-reactive protein, D-dimer, and procalcitonin, interleukin-6, lactate, white blood cell, and neutrophil counts. They also had higher lymphocyte counts, PaO₂/FiO₂ ratio, and glomerular filtration rate at admission. Length of ICU stay was 9 days. The median survival was 11 days for mechanically ventilated patients, and 24 days for patients who were not mechanically ventilated.ConclusionThe parameters that differentiate survivors from non-survivors are in agreement with published data. Further multivariate analyses are warranted to identify individual mortality risk factors.

The first case of coronavirus disease 2019 (COVID-19) in Croatia was confirmed on February 25, 2020 (1). Very soon, on March 11, the World Health Organization (WHO) declared a COVID-19 pandemic (2). As of February 25, 2021, there were more than 240 000 confirmed cases and 5489 deaths in Croatia.As a part of the national strategy against COVID-19 pandemic, the Ministry of Health and Civil Protection Headquarters decided that University Hospital Dubrava (UH) is to be repurposed into a Primary Respiratory Center for patients with confirmed COVID-19 infection. The intensive center of primary respiratory intensive center (PRIC-IC) is a subunit of UH Dubrava reserved for the treatment of patients with severe symptoms of COVID-19 who require mechanical ventilation, vasoactive hemodynamic support, continuous renal replacement therapy, and other aspects of intensive care (3). UH Dubrava became a COVID-19 tertiary center treating a third of all COVID-19 positive ICU patients in the country.As the pandemic was surging through Europe, the number of critically ill COVID-19 patients in UH Dubrava continued to grow, and ICU capacities needed expansion. During winter months, six intensive care units in PRIC were operating at the same time: Three were run by intensivists from UH Dubrava and three by intensivists from other hospitals in Zagreb, including University Hospital Center Zagreb, University Hospital Center Sestre Milosrdnice, University Hospital Sveti Duh, University Hospital Merkur, and Children''s Hospital Zagreb. The outcomes of critically ill patients treated in PRIC-IC therefore represent the work of intensivists from all hospitals in Zagreb.Although scientific knowledge of COVID-19 increases daily, limited information is available regarding early identification of individuals who are at risk of developing severe symptoms. Previous studies reported certain demographic features and clinical characteristics of patients who were likely to develop severe symptoms of COVID-19 and thus require mechanical ventilation (4-7). Studies worldwide reported high mortality rates for patients requiring mechanical ventilation, ranging from 40% to 97% (4,8-10). Unfortunately, some of these reports were preliminary and included patients without a completed ICU stay. The aim of our cohort retrospective study is to describe the demographic characteristic, clinical features, laboratory values, and outcomes among critically ill COVID-19 patients treated in PRIC-IC, UH Dubrava.     

How useful is 3D and 4D ultrasound in perinatal medicine?

AIM: The purpose of this paper is to review and analyze the published literature on the use of three-dimensional (3DUS) and four-dimensional (4DUS) ultrasound in perinatal medicine. METHODS: We systematically searched Medline through PubMED (January 2000-January 2006), including EMBASE/Excerpta Medica database as well as the Cochrane Database of Systematic Reviews. The search terms used to identify clinical application of 3DUS and 4DUS studies in perinatal medicine were technical development, special features, and recommendation for fetal imaging, research on 3DUS or 4DUS, and the usage of invasive 3DUS or 4DUS procedures. The reference bibliographies of relevant books were also manually searched for supplementary citations. Inclusion criteria were as follows: (1) studies related to the use of 3DUS or 4DUS in perinatal medicine; (2) full text were available in English; (3) publication format of original scientific articles, case reports, editorials or literature reviews and chapters in the books. RESULTS: Five hundred and seventy-five articles were identified, and among those, 438 were relevant to this review. CONCLUSIONS: 3DUS and 4DUS provided additional information for the diagnosis of facial anomalies, evaluation of neural tube defects, and skeletal malformations. Additional research is needed to determine the clinical utility of 3DUS and 4DUS for the diagnosis of congenital heart disease, central nervous system (CNS) anomalies and detection of fetal neurodevelopmental impairment assessed by abnormal behavior in high-risk fetuses.     

Dupilumab-induced skin-associated side effects in patients with chronic rhinosinusitis with nasal polyposis

Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a typical type-2 inflammation involving T-helper type-2 cells and impairing quality of life due to nasal obstruction, discharge and reduced sense of smell. Recently, the anti-IL4Rα antibody dupilumab was approved for CRSwNP. While dermatologic side effects in patients treated with dupilumab for atopic dermatitis are frequently observed, there is limited knowledge about these effects in patients with CRSwNP. We aimed to investigate frequency and characteristics of dermatologic side effects following initiation of dupilumab treatment in a cohort of Austrian CRSwNP patients. Therefore, CRSwNP patients presenting at the Department of Otorhinolaryngology, Head and Neck Surgery at the Vienna General Hospital were retrospectively evaluated for newly developed skin eruptions while under dupilumab treatment. Incidence was calculated and details on clinical symptoms were collected. One hundred and ninety-two CRSwNP patients receiving dupilumab treatment were included, comprising a cumulative follow-up of 89.65 years (median: 5.5, IQR: 5.9). We observed dermatologic side effects in four patients starting at a median time of 15.5 (range 4–23) weeks after dupilumab initiation corresponding to an incidence-rate of 4.46 (95%-confidence interval 1.39–11.23) events per 100 patient-years follow-up. The majority (75%, 3/4) of affected patients developed psoriasis-like dermatitis, whereas one individual experienced rosacea-like folliculitis and alopecia areata. While dupilumab dosing was reduced in 3/4 CRSwNP patients, one patient completely stopped dupilumab therapy. Our study provides the first comprehensive evaluation of both frequency and characteristics of dermatologic side effects caused by dupilumab in CRSwNP patients. All affected patients developed Th1-inflammatory associated skin disorders – previously observed only in individuals with prior affections of the skin (i.e. atopic dermatitis). Thus, individuals receiving dupilumab for CRSwNP may develop novel symptoms that require interdisciplinary management. Future studies on dupilumab in a real-world setting will be required to further explore its spectrum of side effects.