Medicina
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Background and Objectives: Our study aimed to cluster dual kidney transplant recipients using an unsupervised machine learning approach to characterize donors and recipients better and to compare the survival outcomes across these various clusters. Materials and Methods: We performed consensus cluster analysis based on recipient-, donor-, and transplant-related characteristics in 2821 dual kidney transplant recipients from 2010 to 2019 in the OPTN/UNOS database. We determined the important characteristics of each assigned cluster and compared the post-transplant outcomes between clusters. ⋯ Two clusters, based on specific recipient and donor characteristics, were identified through an unsupervised machine learning approach. Despite varying differences in donor and recipient age between the two clusters, death-censored graft survival was excellent and comparable. Broader utilization of DKT from high KDPI kidneys and pediatric en bloc kidneys should be encouraged to better address the ongoing organ shortage.
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Background and Objectives: Visceral obesity is associated with chronic low-grade inflammation that predisposes to metabolic syndrome. Indeed, infiltration of adipose tissue with immune-inflammatory cells, including 'classical' inflammatory M1 and anti-inflammatory 'alternative' M2 macrophages, causes the release of a variety of bioactive molecules, resulting in the metabolic complications of obesity. This study examined the relative expression of macrophage phenotypic surface markers, cholesterol efflux proteins, scavenger receptors, and adenosine receptors in human circulating peripheral blood mononuclear cells (PBMCs), isolated from patients with type 2 diabetes mellitus (T2DM), with the aim to phenotypically characterize and identify biomarkers for these ill-defined cells. ⋯ On the other hand, treatment with the antidiabetic drug, metformin, reduced the expression of IL-12 and increased the expression of 27-hydroxylase, LOX-1, CXCL16 and A2AR. Conclusions: PBMCs in the circulation of patients with T2DM express phenotypic markers that are different from those typically present in adipose tissue M1 and M2 macrophages and could be representative of metabolically activated macrophages (MMe)-like cells. Our findings suggest that metformin alters phenotypic markers of MMe-like cells in circulation.
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Background and Objectives: The aim of this study was to retrospectively analyze the duration of treatment and the number of dental radiographs taken during endodontic treatment (endo-t) of young permanent teeth (YPT). Materials and Methods: Age, gender, affected tooth number, apex status, duration of treatment and dental radiographs taken during this period were retrospectively evaluated in pediatric patients aged 6−15 years who presented to the pedodontic department for endo-t of anterior YPT. Data were analyzed with Kruskal Wallis H, Dunn and Pearson chi-square tests. p < 0.05 was accepted as statistically significant in all analyses. ⋯ There was no difference in the number of Pan-R with respect to duration of treatment (p = 0.560). Conclusions: In children, the number of Per-R significantly increased with prolonged duration of treatment encompassing multiple sessions for endo-t procedures of anterior YPT, decided based on the apex and lesion status of the affected tooth. Especially in long-term traditional apexification treatments, treatment should be carried out in children with the ALADAIP (As Low As Diagnostically Achievable being Indication-oriented and Patient-specific) principle in mind.
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Background and Objectives: Anxiety disorders are common in individuals with diabetes mellitus (DM) and have a negative impact on diabetes-related self-management and, therefore, on patients’ evolution and prognosis. In this context, it becomes necessary to accurately and easily assess anxiety and self-management behaviours. Thus, the aim of this research was translation and cultural adaptation for Romanian patients and validation of two instruments used for assessing diabetes self-management and anxiety, namely the Diabetes Self-Management Questionnaire (DSMQ) and the Social Phobia Inventory (SPIN). ⋯ The DSMQ has also proven to have acceptable internal consistency, excellent acceptability of its questions without non-responders and a median completion time of 2 min and 28 s; however, it has shown a weak, positive correlation without statistical significance in comparison with the SDSCA, a previously validated questionnaire. Conclusions: The SPIN, translated in Romanian and culturally adapted, is a valid tool for the screening of social phobias in individuals with DM. The DSMQ requires additional data for its validation in DM patients from Romania.
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Background and objectives: The aim of this systematic review was to assess the available evidence of using enamel matrix derivate in the treatment of peri-implantitis. Materials and methods: Three electronic databases (PubMed, Scopus, and Web of Science) were searched until August 2022 to identify relevant articles. The inclusion criteria consisted in human clinical studies that reported the use of enamel matrix derivate (EMD) in surgical and non-surgical treatment of peri-implantitis. ⋯ Conclusions: The use of EMD indicated a positive effect on both surgical and non-surgical therapy. However, the available literature is scarce, with low evidence in non-surgical approach and modest evidence in surgical approach using EMD. More RCTs with standardize protocols are necessary to evaluate the efficacy of using EMD in both therapies.