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To the Editor: Mycoplasma genitalium is now recognized as a serious pathogen in sexually transmitted infections (1,2). Azithromycin regimens have been commonly used for treatment of M. genitalium infections (3). [...]

Aim: In patients with hepatitis C virus, treatment failure of daclatasvir plus asunaprevir combination therapy (DCV + ASV) seems to become intractable due to the induction of resistance‐associated substitutions. This study aimed to investigate the outcomes of retreatment with direct‐acting antivirals (DAAs) in patients with DCV + ASV therapy failure, as well as changes in drug resistance mutations. Methods: We retrospectively analyzed 44 patients re‐treated with DAAs after DCV + ASV failure between December 2015 and April 2018. All patients were analyzed for amino acid substitutions, and additional treatment regimens were selected based on the results and current treatment guidelines. Results: The sustained virological response rate with second‐line treatment was 81.8% (36/44), and relapse occurred in five of 16 patients who received sofosbuvir/ledipasvir and three of seven patients who received DCV/ASV/beclabuvir. Third‐ and fourth‐line treatments were also tried in relapsed cases, and the overall sustained virological response rates were 90.9% (40/44) and 93.2% (41/44), respectively. A high rate of viral clearance was eventually observed. Before second‐line treatment, the prevalence of mutations in the NS5A and NS3/4A regions was 100% (44/44) and 86.4% (38/44), respectively. There was no significant increase in the number of amino acid substitutions in patients for whom second‐line treatment failed. Conclusions: Amino acid substitutions were frequently observed in patients with DCV + ASV failure, but most patients achieved a sustained virological response after retreatment with DAAs. Although the spread of drug‐resistant viruses due to unsuccessful DAA treatment was a matter of concern, most cases of DCV + ASV failure were overcome with additional treatment. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate the predictive factors of objective response rate (ORR) and progression‐free survival (PFS), and the correlation of albumin‐bilirubin (ALBI) grade with decreased appetite and fatigue in hepatocellular carcinoma patients treated with lenvatinib. Methods: From March 2018 to December 2018, a total of 94 patients was included in this retrospective multicenter study. Results: The median age of all patients was 73 years (interquartile range 66–79.3 years), and approximately 78% patients were men. The ALBI grade was 1, 2, and 3 in 27 (28.7%), 64 (68.1%), and three patients (3.2%), respectively. The Barcelona Clinic Liver Cancer stage was early, intermediate, and advanced in one (1.1%), 22 (23.4%), and 71 patients (75.5%), respectively. Best radiological response was determined to complete response, partial response, stable disease, and progressive disease in 0 (0.0%), 24 (30.4%), 38 (48.1%), and 17 patients (21.5%), respectively, giving the ORR of 30.4%. The 3‐, 6‐, and 12‐month PFS was calculated to be 78.7% (95% CI 70.3–87.1%), 46.7% (95% CI 36.1–57.3%), and 17.4% (95% CI 6.6–28.2%). Multivariate analysis showed that the Barcelona Clinic Liver Cancer intermediate stage was shown to be the only significant factor affecting the ORR (odds ratio 3.78, 95% CI 1.14–12.5, P = 0.030) and PFS (hazard ratio 0.49, 95% CI 0.26–0.94, P = 0.030). The incidence of all grades of decreased appetite and fatigue was significantly less in patients with ALBI grade 1 compared with ALBI grade 2 + 3. Conclusions: The Barcelona Clinic Liver Cancer intermediate stage was the predictive factor affecting the ORR and PFS, and ALBI grade was a good predictive factor affecting the incidence of fatigue and decreased appetite. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess in-vitro interfacial cavity adaptation of different adhesive/composites systems in class-II restoration using SS-OCT and to confirm the findings with a confocal laser scanning microscope (CLSM). Standardized rectangular-shaped class-II cavities were prepared on 24 extracted human molar teeth, bonded with adhesive and lined with flowable composite. Cavities were further restored by bulk filling using packable composite. Specimens were divided into four groups (n = 7) according to restorative materials used; PrimeFil with Estelite Posterior composites (PF; Tokuyama Dental), Clearfil Tri-S Bond Plus with Majesty LV flowable and Majesty Posterior composites (TS; Kuraray Noritake Dental), Adper Easy bond with Filtek Z350 XT flowable and Filtek Z350 XT packable composites (AE; 3 M ESPE) or Palfique Bond adhesive with Estelite Flow Quick flowable and Estelite Posterior composites (BF; Tokuyama Dental). To evaluate the cavity adaptation of these restorative materials, tomographic images of pulpal (P) and gingival (G) walls were obtained by SS-OCT with a central wavelength of 1330 nm, followed by cross-sectioning and CLSM observation to confirm OCT findings. The results showed a significant increase in the backscattered reflection was attributed to the interfacial gaps. AE groups demonstrated the highest interfacial adaptation percentage (p < 0.05), while TS and PF groups showed no significant difference (p > 0.05). BF group presented the least adaptation percentage, and the gaps were frequently observed at the adhesive/composite interface. In addition to the sensitivity of the SS-OCT to the interfacial gaps, the success of flowable lining relies on the interactions between the adhesive/tooth and adhesive/composite substrates. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effects of increasing thermocycling regimens on bond strength and nanoleakage of an etch-and-rinse adhesive. Materials and Methods: Adper Single Bond (3M ESPE) was used for bonding resin composite to human enamel and dentin. Specimens were stored in water (37°C, 24 h) and subjected to thermocycling (5°C and 55°C) in five groups: 1. control (no thermal cycling), 2. 100, 3. 500, 4. 2000, or 5. 10,000 cycles. The microshear bond test was performed at a crosshead speed of 1 mm/min (n = 16). Nanoleakage specimens were immersed in silver nitrate and FE-SEM micrographs were digitally analyzed to calculate silver penetration in three samples. Results: The mean bond strength to enamel was not significantly affected by thermocycling. However, artificial aging decreased dentin bond strength in groups 4 and 5 compared to control. Weibull analysis indicated that the characteristic strength decreased gradually with aging in both substrates. All groups exhibited some nanoleakage, and a significant increase in silver penetration compared to the control was observed in enamel and dentin groups 2 to 5. Conclusion: A nanoleakage increase was detected in an earlier stage of aging than when a significant drop in bond strength was observed, with the dentin bond being more susceptible to deterioration. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate dentin sealing ability and microshear bond strength of two different resin cements. Materials and Methods: Resin composite overlays (Estenia C&B) were fabricated and cemented to mid-dentin surfaces with either a self-adhesive resin cement (RelyX Unicem) or a resin cement with a self-etching primer (Panavia F2.0). After 24 h storage in water, the specimens were sectioned, placed into 50% (w/v) ammoniacal silver nitrate solution for 24 h, exposed to photodeveloping solution and observed using FE-SEM and EDS. Percentage distribution of metallic silver particles in the resin cement/dentin interface was calculated using digital image analysis software. In addition, small resin overlay cylinders were also bonded to dentin using either of the resin cements, and their bonding performance was evaluated with the microshear bond strength test. The statistical significance was defined as p ≤ 0.05. Results: No statistically significant difference was detected in the microshear bond strength between RelyX Unicem and Panavia F2.0 (24.9 ± 4.8 and 26.1 ± 5.3 MPa, respectively, p > 0.05). However, a significant difference was detected in silver particle penetration percentage between RelyX Unicem and Panavia F2.0 (7.4 ± 4.6 and 18.7 ± 8.7 MPa, respectively). The Kruskal-Wallis mean ranks for nanoleakage were 6.8 and 14.2, respectively (p < 0.05). Conclusion: While the bond strengths of the two materials were comparable, the self-adhesive resin cement may provide better dentin sealing compared to the self-etching primer resin cement. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the microshear bond strength of three current adhesives to normal and caries-affected dentin, and to examine the correlation between dentin nanoindentation hardness and bond strength. Materials and Methods: Nanoindentation hardness of dentin and microshear bond strength of Clearfil SE Bond, Clerafil Tri-S Bond (Kuraray Medical) and Single Bond (3M ESPE) were measured on caries-affected and normal dentin. Modes of fracture for the bonding tests and the resin/dentin interfaces were observed using SEM. Data were analyzed at a statistical significance level of p < 0.05. Results: Significantly lower hardness values were recorded for caries-affected dentin compared to normal dentin. Two-way ANOVA showed that bonding material, type of dentin, and the interactions of these two factors had significant effects on bond strength. A significant correlation was found between dentin hardness and microshear bond strength. However, ANCOVA analysis revealed that the effect of dentin type was not only due to the mechanical properties of dentin. One-way ANOVA with Tukey's HSD test revealed that the mean bond strength of normal dentin with Tri-S Bond was significantly lower than that with SE Bond and Single Bond; however, bond strengths to caries-affected dentin showed no significant difference between the three adhesives. Conclusion: All three adhesives showed lower bond strength to caries-affected dentin than to normal dentin. The differences between adhesives were not significant with caries-affected dentin as the bonding substrate. Dentin mechanical properties are not the only factors responsible for lower bond strength to caries-affected dentin. [ABSTRACT FROM AUTHOR]