Search

Background/Objectives: Aesthetics is a challenging aspect to restore for both dentists and dental technicians. One of the characteristics of aesthetic restoration is the shade. The purpose of the study is to assess the accuracy of the shade selection feature of intraoral scanners (CEREC Omnican, 3Shape TRIOS) in comparison with an already established method—the VITA Easyshade V spectrophotometer (VE)—and test if there is any significant difference between the three devices. Methods: To conduct this in vitro study, the VITA Classical shade guide was used. The intraoral scanners would not be able to scan the VITA Classical as it is, hence, a study model (SM) was fabricated. To be able to test the accuracy of the intraoral scanners (IOSs) in detecting the dental color, a spectrophotometer had to be included in the study, as it was shown that it is the most accurate instrument for this purpose. Therefore, for the current study, the VITA Easyshade V spectrophotometer (VITA Zahnfabrik, Bad Sackingen, Germany) was selected. Results: The accuracy of the three devices when measuring the shade of the study model was calculated as a percentage. When comparing the primary results of the VE and the results obtained by the Omnicam and TRIOS, the latter is the most accurate (26.67%), whereas the other two scored 20%. The study also revealed the limitations of the instrumental devices that were used. Conclusions: First, both the VE and IOSs obtained unexpectedly low accuracy results. Possibly, the material VC is made of influenced the final accuracy values, but in practice, on a daily basis, dental materials represent a factor that cannot really be controlled. [ABSTRACT FROM AUTHOR]

Lupus nephritis (LN) is a common clinical manifestation of systemic lupus erythematosus (SLE). Our study aims to quantitatively analyze CD4+ and CD8+ lymphocytes in different areas and LN classes and describe a specific distribution pattern that is correlated with the severity of LN-specific lesions. In total, 53 LN renal biopsies were immunohistochemically investigated using anti-CD4 and anti-CD8 antibodies. T lymphocytes were counted in 3 areas, including intraglomerular, periglomerular, and interstitial regions. The severity of glomerular and tubulo-interstitial lesions was assessed using an original semi-quantitative algorithm based on the renal corpuscle score (RC_S) and the tubulo-interstitial score (TI_S). The number of CD8+ T lymphocytes was higher than that of CD4+ T lymphocytes in each of the three areas and in each LN class, showing statistically significant differences. ANOVA analysis of all LN classes showed significant differences between periglomerular and interstitial CD4+ and CD8+ T lymphocytes, respectively. Irrespective of location, the number of CD8+ T lymphocytes statistically correlates with the RC_S and the TI_S; no significant correlations were found between the number of CD4+ T lymphocytes and the RC_S and the TI_S for all three considered areas. Our data provide strong evidence supporting the major role of CD8+ lymphocytes in LN lesion progression, with CD4+ lymphocytes playing a limited role. [ABSTRACT FROM AUTHOR]

Multimedia resources, such as instructional videos, are currently enjoying a certain popularity in the training programs for medical and dental students. The major challenge is to create such resources with quality content that is approved by students. In order to answer this challenge, it is imperative to find out which features of instructional videos are considered to be necessary and useful by students, thus being able to excite them, to hold their attention, and to stimulate them in learning with pleasure. Aim: We investigated the opinions of a sample of 551 students from four medical universities in Romania, in order to identify the students' preferred characteristics in instructional videos, both globally and comparatively on genders and age groups and also according to their general preferences for using internet services. Material and methods: We used univariate (hypothesis testing) and multivariate (two-step clustering) data analysis techniques and revealed three clusters of students, primarily determined by their perceptions of the visual appearance of the instructional videos. Results: The structure of the clusters by gender and age group was relatively similar, but we recorded differences associated with the students' expressed preferences for certain internet services compared to others. The first identified cluster (35.4% of the cases) contains students who prefer instructional videos to contain images used only for aesthetic purposes and to fill the gaps; they use internet services mainly for communication. The second cluster of students (34.8%) prefers videos designed as practical lessons, using explanatory drawings and diagrams drawn at the same time as the explanations; they also use internet services mainly for communication. The last cluster of students (29.8%) prefer videos designed as PowerPoint presentations, with animated pictures, diagrams, and drawings; they are slightly younger than the others and use internet services mainly for information and communication, but also for domestic facilities. Conclusions: The students' preferences for certain features of instructional videos depend not only on gender and age but are also related to their developmental background and general opinions about modern technologies. [ABSTRACT FROM AUTHOR]

(1) Objective: The main aims of our study were to explore the drug survival and effectiveness of secukinumab in patients with axial spondyloarthritis (axSpA). (2) Methods: We underwent a retrospective analysis of consecutive axSpA treated with secukinumab as a first line of biologics or at switch in a biologic-experienced population. Efficacy data, indicating improvement in inflammation parameters (such as C-reactive protein and erythrocyte sedimentation rate) and disease activity scores (such as Ankylosing Spondylitis Disease Activity Score [ASDAS-CRP], Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]), and patient-reported outcomes (pain), were assessed at 6, 12, 24, 36 and 48 months. The drug survival rate, dropout rate and discontinuation reasons (efficacy versus safety) of secukinumab were assessed in subgroup analysis (axSpA with and without exposure to biologics). (3) Results: In total, 46 patients were exposed to the IL-17A inhibitor secukinumab. The drug survival for axSpA patients 59.7% at 12 months and 31.3% at 24 months. There were no statistically significant differences in the median drug survival between biologic-naïve versus biologic-experienced subgroups. (4) Conclusions: Secukinumab has demonstrated effectiveness and safety in treating a cohort of axSpA patients in real-world settings, with a notable retention rate of the drug. [ABSTRACT FROM AUTHOR]

Dental composites, through their structural diversity, represent the biomaterials frequently used in dental reconstructive therapy. The aim of our study was to observe the influence of different beverage environment conditions on seven types of obturation dental materials with different compositions. Our research focused on the surface modification analysis of the materials after the immersion in the different beverages; in this regard, we used the EDAX technique correlated with the energy-dispersive X-ray fluorescence (XRF). The pH of the drinks and that of the simulated saliva solution were determined by the titrimetric method, a sodium hydroxide solution 0.1 mol/dm3 was prepared and used for the titration. An amount of 5 mL of each analyzed solution was added to 15 mL of distilled water to obtain a dilution, to which 3 drops of phenolphthalein (as a color indicator—Phenolphthalein, 3,3-Bis(4-hydroxyphenyl)-1(3H)-isobenzofuranone, C20H14O4 Mw: 318.32, purchased from Merck) were added for each analysis. For each solution, the experiment was repeated three times in order to obtain accurate results. The results of our study materialized into a real plea for modifying the patients' behavior in terms of diet and preferences for acidic drinks, so that their quality-of-life valence can be improved by keeping the composite materials in a long-term unalterable state on the one hand; on the other hand, systemic damage can be prevented as well. [ABSTRACT FROM AUTHOR]

The success of blended learning programmes, based on digital tools, depends on several factors that significantly influence students' performance, of which demographics (gender and age group) are the most common. Other factors play an important role too. Among these, we focused on the students' general attitude towards the digital environment and the importance they attach to it in their daily activities. We investigated a sample of five hundred fifty-one students from four Medical Universities in Romania, mostly females (76.2%), from years 1 and 2 of study (63.7%) and aged between 18 and 20 years (53.9%), and we recorded their general opinion about the effectiveness of four types of teaching tools and the intensity of using Internet services in their daily activities. We conducted univariate (hypothesis testing) and multivariate (two-step clustering) analyses of the recorded responses, and we found that the students' general behaviour as the users of Internet services significantly influences their choices for certain teaching tools over others. Students who prefer classic oral presentations and PowerPoint presentations are predominantly females, aged between 18 and 20, who use Internet services mainly for communication. Students who prefer educational videos are also mainly females, evenly distributed by age groups; they enjoy using multimedia resources during learning and use Internet services for communication, information or entertainment. Students who prefer the use of online documentary sources are evenly distributed by gender and are over 20 years of age; they also enjoy using multimedia resources during learning and use Internet services mainly for communication and information. The obtained results show that, to optimally combine the teaching tools used in blended learning, it is useful to assess in advance the attitude towards the digital environment of the students to whom it is addressed. [ABSTRACT FROM AUTHOR]

The progression of liver fibrosis and the presence of portal hypertension are two key points in the follow-up and severity assessment of patients with chronic liver disease. Objective evaluation of such aspects has proven to be difficult due to the lack of reproducible and standardized non-invasive methods. Therefore, the aim of this study was to evaluate whether spleen stiffness (SS) can rule out the presence of high-risk varices (HRVs) in patients with non-alcoholic fatty liver disease (NAFLD). We designed a prospective follow-up of a cohort of 48 consecutive patients diagnosed with compensated advanced chronic liver disease (cACLD) due to NAFLD, between January 2020 and January 2021. After clinical evaluation, laboratory testing, ultrasonography (US), and shear-wave elastography (2D-SWE.GE) of both the liver and the spleen, patients were endoscopically screened for esophageal varices, gastric varices, and portal hypertensive gastropathy. Correlations and predictors were assessed. After univariate, multivariate, and predictive analyses, SS could be referred to as an independent predictor for high-risk varices (AUROC 0.987, p < 0.001, OR 4.985, 95% CI: 1.57–15.73, p = 0.006), with a calculated cutoff value of 17.95 kPa. These results are consistent with those of other, similar studies using both 2D-SWE.GE and a similar module (2D-SWE.SSI) in patients with metabolic liver disease. When confirmed by subsequent larger studies, SS could potentially become a useful non-invasive tool in the assessment of clinically significant portal hypertension in patients with advanced fatty liver disease. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic highlighted e-learning as a critical component that ensured the continuity of students' education processes. In this regard, many research groups aim to provide new scientific data about the efficiency and benefits of e-learning for healthcare students. Our study aims to evaluate the attraction of e-learning among medical and dental Romanian students, in association with their preferences as internet and computer consumers. The study enrolled 551 students in medicine from four Romanian Universities of Medicine and Pharmacy, located in major cities (Iași—64.6%, Craiova—19.6%, Timișoara—14.5% and Cluj Napoca—1.3%), mostly females (76.2%), from the first and second years of study (63.7%) or the fourth to sixth years of study (23.3%), aged 18–20 years (53.9%). To investigate their opinions about the efficiency of e-learning, we used an anonymous questionnaire with 31 items regarding advantages (17 items) and possible drawbacks (14 items). The students in medicine had favourable opinions about online learning because these tools are more comfortable (75.2%) and more flexible (60.1%). The main reasons for disagreement were the lack of direct communication and human interaction with teachers (53.2%), limitations due to the particularities of some disciplines that cannot be easily transferred to the online environment (46.4%), and the lack of proper motivation (32.5%). Older students, who liked to use multimedia resources in the learning process and used the internet mainly for information purposes or domestic facilities, had the highest scores for favourable opinions about online learning. The younger students, who did not prefer using multimedia resources in the learning process, also had the highest scores for disagreement regarding online learning. There were no statistically significant differences between genders. [ABSTRACT FROM AUTHOR]

Introduction: Orofacial pain is a common occurrence in daily dental practice; it is frequently attributed to temporomandibular dysfunction, one of its major causes, followed by pathology of the salivary glands, without avoiding interference at the level of the pain pathways caused by complications of periodontal pathology. The main objective of this study is to identify an important cause of pain in the oral–maxillofacial territory by quantifying the changes at the salivary glandular level using stereological methods. The secondary objective of the present research is to identify the implications of periodontal changes as a consequence of salivary quantitative and qualitative changes, quantified using periodontal indices, on the balance of the temporomandibular joint, dysfunction of it being an important cause of facial pain and having a profound impact on the complex oral rehabilitation algorithm of each clinical case, a condition evaluated with the analysis of the results of the Souleroy questionnaire. Material and methods: In a retrospective study, we evaluated the clinical results obtained after applying complex rehabilitation treatment to 35 subjects, 20 women and 15 men with salivary and TMJ dysfunctions, selected between 2020 and 2021 from the Clinic of Maxillofacial Surgery, Iasi. Results and discussion: The most common symptoms of temporomandibular disorders (TMDs) that were identified through the Souleroy questionnaire were pain and different types of damage to the masticatory muscles. The most significant changes in elders are reported in the case of serous cells, which reduced their percentage volume from 46.7% to 37.4%. Conclusion: As regards stereological analysis in conjunction with histological images, there were significant changes in diameters, perimeters, and longitudinal axes in the adult patients as opposed to the elderly patients, which were also influenced by the type of pathology at this level. The scores recorded on the diagnostic Souleroy scale indicated a large number of patients with low efficiency and maximum stress levels: 20.0% in level 1, 25.7% in level 2, and 25.7% in level 3. [ABSTRACT FROM AUTHOR]

Bullying and cyberbullying victimization are significant factors that threaten adolescent development and mental health. Our study aimed to analyze how socioeconomic characteristics and personal experiences of violence are associated with adolescents' experiences of bullying and cyberbullying victimization. The study participants were 1146 students, 698 females and 448 males, aged between 13 and 16 years old, from secondary schools in Spain, Italy, Romania, Portugal, Poland and the UK. Data was collected through an online questionnaire. Prevalence ratios (PR) were calculated using Poisson regression with robust variance. In total, 37.2% of girls and 35.0% of boys reported being victims of bullying and or cyberbullying. The likelihood of bullying and or cyberbullying victimization was higher when adolescents had experienced physical and or sexual abuse before the age of 15, had witnessed domestic violence against their mother or had been victims of intimate partner violence. Perceived social support from teachers and classmates and higher self-esteem were associated with a lower likelihood of becoming a victim of bullying and or cyberbullying, but an association between experience of any other form of violence and the greater possibility of becoming a victim of bullying and or cyberbullying persisted even when self-esteem and social support were included in the model. Protecting adolescents from bullying and or cyberbullying means preventing all exposure to violent experiences in childhood and adolescence. Not having such experiences seems to be the most relevant protective factor. [ABSTRACT FROM AUTHOR]

The assessment of fibrosis in chronic liver diseases using non-invasive methods is an important topic in hepatology. The aim of this study is to identify patients with non-alcoholic fatty liver disease (NAFLD) and advanced liver fibrosis by establishing correlations between biological/ultrasound markers and non-invasively measured liver stiffness. This study enrolled 116 patients with non-alcoholic fatty liver disease, which were evaluated clinically, biologically, and by ultrasound. Liver fibrosis was quantified by measuring liver stiffness by shear wave elastography (SWE). Multiple correlation analysis of predictors of liver fibrosis identified a number of clinical, biological, and ultrasound parameters (BMI, blood glucose, albumin, platelet count, portal vein diameter, bipolar spleen diameter) that are associated with advanced liver fibrosis in patients with non-alcoholic fatty liver disease. The correlations between the degree of liver fibrosis and the risk values of some serological and ultrasound markers obtained in our study could be useful in clinical practice for the identification of advanced fibrosis in patients with NAFLD. [ABSTRACT FROM AUTHOR]

The aim of our study was to correlate systemic bone loss by evaluating human Dickkopf-related protein 1 (Dkk-1) biomarker compared to horizontal bone loss as well as the presence and size of periapical lesions assessed by dental X-ray (ortopantomography—OPT) and cone beam computed tomography (CBCT) in patients with cancer in the ears, nose and throat (ENT) region vs. healthy controls. The study included 63 subjects divided into a study group of 33 cancer patients with ENT cancer (larynx/oropharynx/sinuses) and a control group of 30 healthy individuals. Blood samples were collected from both groups to assess Dkk-1 level using a sandwich enzyme immunoassay. The dental radiological examination consisted of a panoramic X-ray and a CBCT in order to appraise the horizontal bone loss, the presence and size of the periapical lesions in 2D vs. 3D images. The panoramic X-ray showed that in the control group, the maximum bone loss reached 13.2 mm, with an average of 4.930 ± 3.258 mm, while in the study group, the maximum horizontal bone loss was 11.3 mm, with an average of 5.191 ± 2.109 mm. The CBCT 3D investigation, when compared to the OPT, showed increased values for horizontal bone loss, both in the control group and in the study group; in the control group, the maximum bone loss reached 14.10 mm, with an average of 5.736 ± 3.471 mm, and in the study group, the maximum value was 12.40 mm, and the average was again slightly higher (6.152 ± 2.519 mm). The mean value for Dkk-1 in cancer patients was 1.209 ± 0.110 ng/mL, significantly lower than the value observed in healthy patients (1.712 ± 0.100 ng/mL). CBCT revealed higher values for the investigated parameters when compared to panoramic X-rays. Taking into account the preliminary nature of our study, we observed a significant correlation between the level of bone loss recorded by the Dkk-1 biomarker and radiological dental examination in patients with ENT cancer when compared to the control group. [ABSTRACT FROM AUTHOR]

Over recent years, studies have shown that in patients with left-sided heart failure, arterial hypertension, and acute coronary syndrome, hyponatremia is a negative prognostic factor. In this context, there is raising interest in the association between hyponatremia and pulmonary embolism (PE). This retrospective cohort study includes 404 consecutive patients with confirmed acute nonfatal pulmonary embolism divided into four groups according to their sodium fluctuation pattern. The primary outcome was all-cause mortality and determining the recurrence rate among patients with nonfatal PE using serum sodium levels as a continuous variable. Patients with acquired and persistent hyponatremia had a significantly higher rate of mortality rate than those in the normonatremia group (12.8% and 40.4%, OR- 7.206, CI: 2.383–21.791, p = 0.000 and OR-33.250, CI: 11.521–95.960, p = 0.000 vs. 2%, p < 0.001, respectively). Mean survival time decreases from 23.624 months (95% CI: (23.295–23.953)) in the normonatremia group to 16.426 months (95% CI: (13.17–19.134)) in the persistent hyponatremia group, statistically significant (p = 0.000). The mean survival time for all patients was 22.441 months (95% CI: (21.930–22.951)). The highest recurrence rate was recorded at 12 and 24 months in the acquired hyponatremia group (16.7% and 14.1%, respectively). Serum sodium determination is a simple and cost-effective approach in evaluating the short and long-term prognosis in patients with acute PE. [ABSTRACT FROM AUTHOR]