Στην βιολογία, το περιβάλλον μπορεί να καθοριστεί σαν ενα σύνολο κλιματικών, βιοτικών, κοινωνικών και εδαφικών παραγόντων που δρουν σε έναν οργανισμό και καθορίζουν την ανάπτυξη και την επιβίωση του. Έτσι, περιλαμβάνει οτιδήποτε μπορεί να επηρεάσει άμεσα τον μεταβολισμό ή τη συμπεριφορά των ζωντανών οργανισμών ή ειδών, όπως το φως, ο αέρας, το νερό, το έδαφος και άλλοι παράγοντες. Δείτε επίσης το άρθρο για το φυσικό περιβάλλον και τη φυσική επιλογή.
Στην αρχιτεκτονική, την εργονομία και την ασφάλεια στην εργασία, περιβάλλον είναι το σύνολο των χαρακτηριστικών ενός δωματίου ή κτιρίου που επηρεάζουν την ποιότητα ζωής και την αποδοτικότητα, περιλαμβανομένων των διαστάσεων και της διαρρύθμισης των χώρων διαβίωσης και της επίπλωσης, του φωτισμού, του αερισμού, της θερμοκρασίας, του θορύβου κλπ. Επίσης μπορεί να αναφέρεται στο σύνολο των δομικών κατασκευών. Δείτε επίσης το άρθρο για το δομημένο περιβάλλον.
Στην ψυχολογία, περιβαλλοντισμός είναι η θεωρία ότι το περιβάλλον (με τη γενική και κοινωνική έννοια) παίζει μεγαλύτερο ρόλο από την κληρονομικότητα καθορίζοντας την ανάπτυξη ενός ατόμου. Συγκεκριμένα, το περιβάλλον είναι ένας σημαντικός παράγοντας πολλών ψυχολογικών θεωριών.
Στην τέχνη, το περιβάλλον αποτελεί κινητήριο μοχλό και μούσα εμπνέοντας τους ζωγράφους ή τους ποιητές. Σε όλες τις μορφές της Τέχνης αποτελεί έμπνευση και οι Καλές Τέχνες φανερώνουν την επιρροή οπού άσκησε σε όλους τους καλλιτέχνες με όποιο είδος Τέχνης κι αν ασχολούνται. Ο άνθρωπος μέσα στο περιβάλλον δημιουργεί Μουσική, Ζωγραφική, Ποίηση, Γλυπτική, χορό, τραγούδι, θέατρο, αλλά και όλες οι μορφές τέχνης έχουν άμεση έμπνευση από το περιβάλλον.

Δευτέρα 1 Ιουλίου 2019

Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

European Journal of Surgical Oncology (EJSO), Treatment of mid-bile duct carcinoma: Local resection...
European Journal of Surgical Oncology (EJSO),Treatment of mid-bile duct carcinoma: Local resection or pancreatoduodenectomy?Publication date: Available online 29 June 2019Source: European Journal of Surgical OncologyAuthor(s): A. Marthe Schreuder, Anton F. Engelsman, Stijn van Roessel, Joanne Verheij, Marc G. Besselink, Thomas M. van Gulik, Olivier R. BuschAbstractIntroductionWhereas distal cholangiocarcinoma (DC) is treated by pancreatoduodenectomy (PD), consensus is lacking on treatment of mid-bile...
Αλέξανδρος Γ. Σφακιανάκης
1m
 Psycho-Oncology, Barriers and Facilitators to Community‐Based Psycho‐oncology Services: A Qualitative...
 Psycho-Oncology,Barriers and Facilitators to Community‐Based Psycho‐oncology Services: A Qualitative Study of Health Professionals' Attitudes to the Feasibility and Acceptability of a Shared Care ModelAbstract Objective Psychological therapies combined with medication are effective treatments for depression and anxiety in patients with cancer. However, the psycho‐oncology workforce is insufficient to meet patient need and is hard to access outside of major cities. To bridge this gap, innovative...
Αλέξανδρος Γ. Σφακιανάκης
2m
Cancer Treatment Reviews
Drug-induced gene expression profile changes in relation to intestinal toxicity: State-of-the-art and new approachesPublication date: Available online 27 June 2019Source: Cancer Treatment ReviewsAuthor(s): Daniela Rodrigues, Terezinha Souza, Danyel G.J. Jennen, Lieve Lemmens, Jos C.S. Kleinjans, Theo M. de KokAbstractOne of the major complications that patients experience during pharmacological treatment is the occurrence of adverse drug reactions (ADRs). The most affected organs are the liver, kidney,...
Αλέξανδρος Γ. Σφακιανάκης
2m
Cancer Epidemiology, The burden of squamous cell carcinoma of the conjunctiva in Africa Publication...
Cancer Epidemiology,The burden of squamous cell carcinoma of the conjunctiva in AfricaPublication date: August 2019Source: Cancer Epidemiology, Volume 61Author(s): Lucia Hämmerl, Jacques Ferlay, Margaret Borok, Carla Carrilho, Donald Maxwell ParkinAbstractSquamous cell carcinoma of the conjunctiva (SCCC) is a relatively common cancer in Africa, although its precise incidence and geographic distribution have not been previously systematically studied.MethodsUsing the methods employed to produce national...
Αλέξανδρος Γ. Σφακιανάκης
2m
Cancer Cell, RAC1<sup>P29S</sup> Induces a Mesenchymal Phenotypic Switch via Serum...
Cancer Cell,RAC1<sup>P29S</sup> Induces a Mesenchymal Phenotypic Switch via Serum Response Factor to Promote Melanoma Development and Therapy ResistancePublication date: Available online 27 June 2019Source: Cancer CellAuthor(s): Daniël A. Lionarons, David C. Hancock, Sareena Rana, Philip East, Christopher Moore, Miguel M. Murillo, Joana Carvalho, Bradley Spencer-Dene, Eleanor Herbert, Gordon Stamp, Djamil Damry, Dinis P. Calado, Ian Rosewell, Ralph Fritsch, Richard R. Neubig, Miriam Molina-Arcas,...
Αλέξανδρος Γ. Σφακιανάκης
2m
Cance... Interference with the Bromodomain Epigenome Readers Drives p21 Expression and Tumor Senescence...
Cance...Interference with the Bromodomain Epigenome Readers Drives p21 Expression and Tumor SenescencePublication date: Available online 29 June 2019Source: Cancer LettersAuthor(s): Liana P. Webber, Veronica Q. Yujra, Pablo A. Vargas, Manoela D. Martins, Cristiane H. Squarize, Rogerio M. CastilhoAbstractHead and neck cancer (HNSCC) are one of the most common solid malignancies of the world, being responsible for over 350,000 deaths every year. Much of the complications in managing and treating HNSCC...
Αλέξανδρος Γ. Σφακιανάκης
3m
Elsevier Biochimica et Biophysica Acta (BBA) - Reviews on Cancer
Fibroblasts in cancer: Defining target structures for therapeutic interventionPublication date: Available online 29 June 2019Source: Biochimica et Biophysica Acta (BBA) - Reviews on CancerAuthor(s): Maximilian Boesch, Florent Baty, Holger Rumpold, Sieghart Sopper, Dominik Wolf, Martin H. BrutscheAbstractThe functional importance of the tumor stroma for cancer growth and progression is increasingly recognized, but has not resulted in notable therapeutic developments yet. Within the mesenchymal tumor...
Αλέξανδρος Γ. Σφακιανάκης
4m
Feasibility of proton FLASH effect tested by zebrafish embryo irradiation Sat Jun 29, 2019 03:00 ...
Feasibility of proton FLASH effect tested by zebrafish embryo irradiationSat Jun 29, 2019 03:00by Elke Beyreuther, Michael Brand, Stefan Hans, Katalin Hideghéty, Leonhard Karsch, Elisabeth Leßmann, Michael Schürer, Emília Rita Szabó, Jörg Pawelke via Radiotherapy and OncologyDuring the last decades, radiotherapy dose delivery techniques were notably improved with respect to tumor conformity, e.g., by sophisticated beam delivery techniques like intensity modulated radiation therapy. One disadvantage...
Αλέξανδρος Γ. Σφακιανάκης
4m
 Radiation and Environmental Biophysics, Radiation interaction parameters for blood samples of...
 Radiation and Environmental Biophysics,Radiation interaction parameters for blood samples of breast cancer patients: an MCNP studyAbstract The main goal of this study was to determine radiation interaction parameters such as mass attenuation coefficients, effective atomic numbers, and effective electron densities depending on element concentrations (Na, K, Cu, Zn, Al, Ca, Mg Cr, Fe, Se) in blood samples of patients with breast cancer. Eighty blood samples were collected and analyzed in this study...
Αλέξανδρος Γ. Σφακιανάκης
6m
 Practical Radiation Oncology, Thoracic radiotherapy in patients with entirely intracardiac...
 Practical Radiation Oncology,Thoracic radiotherapy in patients with entirely intracardiac leadless cardiovascular implantable electronic devices: two case reports and a review of the literaturePublication date: Available online 29 June 2019Source: Practical Radiation OncologyAuthor(s): Cory Pierson, Runyon Woods, Rajasekhar Nekkanti, Hyder Arastu, Robert Corns, Andrew W. JuPractical Radiation OncologySat Jun 29, 2019 13:51Quality of life and decision regret after postoperative radiation therapy...
Αλέξανδρος Γ. Σφακιανάκης
6m
Coxsackie B is responsible for the onset of many diseases, some of which include: the common cold, pleurodynia (sudden attacks of pain of soreness of the muscles between the ribs), aseptic meningitis (inflammation of the membranes surrounding the brain and spinal cord), upper respiratory tract (nasopharynx, oral cavity and throat) infection, myocarditis and pericarditis (inflammation of the membranous sac that surrounds and protects the heart). Coxsackie B viruses have also been known to cause: encephalitis (inflammation of the brain), flaccid motor paralysis (paralysis with loss of muscle tone), exanthema (appearance of lesions on the skin), rash, pneumonia (inflammation of the lungs) and generalized disease of the newborn.
WHAT IS COXSACKIE B VIRUS?The Coxsackie virus was first isolated in Coxsackie, New York in 1948. There are sixdifferent Coxsackie B viruses, each responsible for different symptoms and diseases.Coxsackie B viruses are responsible for numerous cases of central nervous systeminfections in infants and children, as well as heart muscle infections in both childrenand adults. These viruses are the most common agent for myocarditis (inflammationof the muscular walls of the heart) and dilated cardiomyopathy...
Αλέξανδρος Γ. Σφακιανάκης
32m
Tests for coxsackie B virus-specific 1gM
J. Hyg., Camb. (1983), 90, 327-332 327Printed in Great BritainEDITORIALTests for coxsackie B virus-specific 1gMDuring the last 10-15 years there has been a relative decline in virus isolationprocedures and an increasing emphasis on both direct antigen detection byimmunological methods and serological tests for the diagnosis of recent virusinfections. This relative decline has been due to a number of factors. There havebeen increasing difficulties in maintaining a suitably wide range of cell culturesystems...
Αλέξανδρος Γ. Σφακιανάκης
34m
 Practical Radiation Oncology, Thoracic radiotherapy in patients with entirely intracardiac...
 Practical Radiation Oncology,Thoracic radiotherapy in patients with entirely intracardiac leadless cardiovascular implantable electronic devices: two case reports and a review of the literaturePublication date: Available online 29 June 2019Source: Practical Radiation OncologyAuthor(s): Cory Pierson, Runyon Woods, Rajasekhar Nekkanti, Hyder Arastu, Robert Corns, Andrew W. JuPractical Radiation OncologySat Jun 29, 2019 13:51Quality of life and decision regret after postoperative radiation therapy...
Αλέξανδρος Γ. Σφακιανάκης
37m
 Pediatric Blood & Cancer, A newborn case of jejunal ALK‐negative inflammatory myofibroblastic...
 Pediatric Blood & Cancer,A newborn case of jejunal ALK‐negative inflammatory myofibroblastic tumor with ETV6‐NTRK3 fusionPediatric Blood & CancerFri Jun 28, 2019 22:00Sustained remission with azacitidine monotherapy and an aberrant precursor B‐lymphoblast population in juvenile myelomonocytic leukemiaAbstract Juvenile myelomonocytic leukemia (JMML) has a poor prognosis in general, with hematopoietic stem cell transplant (HSCT) remaining the standard of care for cure. The hypomethylating...
Αλέξανδρος Γ. Σφακιανάκης
37m
 Clinical Cancer Research current issue, Functional and Mechanistic Interrogation of BET Bromodomain...
 Clinical Cancer Research current issue,Functional and Mechanistic Interrogation of BET Bromodomain Degraders for the Treatment of Metastatic Castration-resistant Prostate CancerPurpose:The bromodomain and extraterminal (BET)-containing proteins (BRD2/3/4) are essential epigenetic coregulators for prostate cancer growth. BRD inhibitors have shown promise for treatment of metastatic castration-resistant prostate cancer (mCRPC), and have been shown to function even in the context of resistance to next-generation...
Αλέξανδρος Γ. Σφακιανάκης
37m
Fibroblast growth factor receptor promotes progression of cutaneous squamous cell carcinoma Sat Jun...
Fibroblast growth factor receptor promotes progression of cutaneous squamous cell carcinomaSat Jun 29, 2019 15:28by Alok R. Khandelwal, Burton Kent, Savage Hillary, Md Maksudul Alam, Xiaohua Ma, Xin Gu, John DiGiovanni, Cherie‐Ann O. Nathanvia Molecular CarcinogenesisAbstractCutaneous squamous cell carcinoma (cSCC) is a keratinocyte‐derived invasive and metastatic tumor of the skin. It is the second‐most commonly diagnosed form of skin cancer striking 200 000 Americans annually. Further, in organ...
Αλέξανδρος Γ. Σφακιανάκης
38m
 Molecular Cancer Therapeutics Online First Articles, Monomer preference of EGFR tyrosine kinase...
 Molecular Cancer Therapeutics Online First Articles,Monomer preference of EGFR tyrosine kinase inhibitors influences the synergistic efficacy of combination therapy with cetuximabEpidermal growth factor receptor (EGFR)-mutated lung cancer is a significant subgroup of non-small cell lung cancer. To inhibit EGFR-mediated signals, multiple EGFR tyrosine kinase inhibitors (EGFR-TKIs) have been developed; however, approximately one-third of patients with EGFR-mutated lung cancer do not respond to EGFR-TKIs....
Αλέξανδρος Γ. Σφακιανάκης
39m
 Molecular Cancer Therapeutics current issue, Highlights of This Issue Molecular Cancer Therapeutics...
 Molecular Cancer Therapeutics current issue,Highlights of This IssueMolecular Cancer Therapeutics current issue10:05A Novel Fully Human Antibody targeting Extracellular Domain of PSMA Inhibits Tumor Growth in Prostate CancerProstate cancer is the most commonly diagnosed malignancy in men and the second leading cause of cancer-related death. It is of vital importance to develop new strategies for prostate cancer therapy. PSMA (prostate-specific membrane antigen) is specifically expressed in prostate...
Αλέξανδρος Γ. Σφακιανάκης
39m
 Latest Results for Genes, Analysis of longissimus muscle quality characteristics and associations...
 Latest Results for Genes,Analysis of longissimus muscle quality characteristics and associations with DNA methylation status in cattleAbstract Background As cattle represent one of the most important livestock species for meat production, control of muscle development in regards to quality is an important research focus. Objectives In this study, the phenotypic quality traits and its associations with DNA methylation levels of the longissimus muscle in two cattle breeds were studied. ...Latest Results...
Αλέξανδρος Γ. Σφακιανάκης
40m
Reduced CTL motility and activity in avascular tumor areas Fri Jun 28, 2019 03:00 via Latest...
Reduced CTL motility and activity in avascular tumor areasFri Jun 28, 2019 03:00via Latest Results for Cancer Immunology, ImmunotherapyAbstractPatchy infiltration of tumors by cytotoxic T cells (CTLs) predicts poorer prognosis for cancer patients. The factors limiting intratumoral CTL dissemination, though, are poorly understood. To study CTL dissemination in tumors, we histologically examined human melanoma samples and used mice to image B16-OVA tumors infiltrated by OT-I CTLs using intravital two-photon...
Αλέξανδρος Γ. Σφακιανάκης
40m
Molecular analysis of virulence factors of hypermucoviscous <em>Klebsiella pneumoniae</em>...
Molecular analysis of virulence factors of hypermucoviscous <em>Klebsiella pneumoniae</em> in a diabetes patient with multifocal intramuscular and musculoskeletal abscessesSun Jun 30, 2019 17:24via Journal of Infection and ChemotherapyPublication date: Available online 29 June 2019Source: Journal of Infection and ChemotherapyAuthor(s): Masataka Kudo, Takashi Matono, Masatomo Morita, Hidemasa Izumiya, Makoto Ohnishi, Junichi Hasegawa, Migiwa Izumi, Mai Yoshino, Ken Arai, Hiroshi ImuraAbstractUnusual...
Αλέξανδρος Γ. Σφακιανάκης
41m
HNL (Human Neutrophil Lipocalin) and a multimarker approach to the distinction between bacterial and...
HNL (Human Neutrophil Lipocalin) and a multimarker approach to the distinction between bacterial and viral infections.Sun Jun 23, 2019 00:00by Journal of Immunological Methods via Journal of Immunological MethodsCONCLUSION: The diagnostic performance of whole blood activated HNL was superior in the distinction between bacterial or viral infections. The addition of IP-10 and/or TRAIL to the diagnostic algorithm increased the performance of B-HNL further. The rapid analysis of HNL, reflecting bacterial...
Αλέξανδρος Γ. Σφακιανάκης
41m
 International Journal of Cancer, Cancer in Africa 2018: the role of infections We estimate the...
 International Journal of Cancer,Cancer in Africa 2018: the role of infectionsWe estimate the fractions of cancer attributed to infections in Africa in 2018. The number of new cancer cases occurring were taken from Globocan2018 with some additional estimations based on data from African population‐based registries. Population attributable fractions were calculated using prevalence of infection and relative risk in exposed versus non‐exposed. The greatest share of infection‐associated cancers is due...
Αλέξανδρος Γ. Σφακιανάκης
41m
The value of cytokine levels in triage and risk prediction for women with persistent high-risk human...
The value of cytokine levels in triage and risk prediction for women with persistent high-risk human papilloma virus infection of the cervixBohan Li, Ling Zhang, Jianguo Zhao, Guichun Tan, Wenwen Zhang, Na Zhang, Jing Tian and Pengpeng QuEmail authorView ORCID ID profileInfectious Agents and Cancer201914:16https://doi.org/10.1186/s13027-019-0231-z© The Author(s). 2019Received: 1 March 2019Accepted: 7 June 2019Published: 28 June 2019AbstractBackgroundCervical cancer is a common cancer among women...
Αλέξανδρος Γ. Σφακιανάκης
42m
 Current Treatment Options in Oncology, Emerging Role of Genomics and Cell-Free DNA in Breast...
 Current Treatment Options in Oncology,Emerging Role of Genomics and Cell-Free DNA in Breast CancerOpinion statement Precision Medicine is gaining momentum as the future gold standard healthcare strategy as it enables treatment optimization and consequently a potential improvement for quality of life and survival. This paradigm shift was possible thanks to new high-throughput genomics technologies, which provide prognostic and predictive information on tumor biology and potential treatment options,...
Αλέξανδρος Γ. Σφακιανάκης
43m
 Critical Reviews in Oncology/Hematology (open access), Clinical Considerations for the Use...
 Critical Reviews in Oncology/Hematology (open access),Clinical Considerations for the Use of FLT3 Inhibitors in Acute Myeloid LeukemiaPublication date: Available online 28 June 2019Source: Critical Reviews in Oncology/HematologyAuthor(s): Taylor M. Weis, Bernard L. Marini, Dale L. Bixby, Anthony J. PerissinottiAbstractInternal tandem duplications and tyrosine kinase mutations in the fms-like tyrosine kinase 3 (FLT3) receptor can occur in acute myeloid leukemia (AML) and portend a poor prognosis....
Αλέξανδρος Γ. Σφακιανάκης
43m
 Comparative and Functional Genomics —  Overexpression of SlGRAS7 Affects Multiple Behaviors Leading...
 Comparative and Functional Genomics — Overexpression of SlGRAS7 Affects Multiple Behaviors Leading to Confer Abiotic Stresses Tolerance and Impacts Gibberellin and Auxin Signaling in TomatoAbiotic stresses remain the key environmental issues that reduce plant development and therefore affect crop production. Transcription factors, such as the GRAS family, are involved in various functions of abiotic stresses and plant growth. The GRAS family of tomato (Solanum lycopersicum), SlGRAS7, is described...
Αλέξανδρος Γ. Σφακιανάκης
44m
 Clinical Cancer Research Online First Articles, Prognostic score and cytogenetic risk classification...
 Clinical Cancer Research Online First Articles,Prognostic score and cytogenetic risk classification for chronic lymphocytic leukemia patients: Center for International Blood and Marrow Transplant Research reportPurpose: To develop a prognostic model and cytogenetic risk classification for previously treated patients with chronic lymphocytic leukemia (CLL) undergoing reduced intensity conditioning (RIC) allogeneic hematopoietic cell transplantation (HCT). Experimental Design: We performed a retrospective...
Αλέξανδρος Γ. Σφακιανάκης
44m
 Clinical and Translational Science, Dose Finding in the Clinical Development of 60 US Food and...
 Clinical and Translational Science,Dose Finding in the Clinical Development of 60 US Food and Drug Administration–Approved Drugs Compared With Learning vs. Confirming RecommendationsThis review characterizes clinical development that supported the label dose in 60 drug indications recently approved by the US Food and Drug Administration. With Lewis B. Sheiner's Learning vs. Confirming clinical drug development paradigm as a reference point, the clinical development paths, the design of dose‐ranging...
Αλέξανδρος Γ. Σφακιανάκης
44m
 Cancer Research current issue, APC/C-CDH1-Regulated IDH3{beta} Coordinates with the Cell Cycle...
 Cancer Research current issue,APC/C-CDH1-Regulated IDH3{beta} Coordinates with the Cell Cycle to Promote Cell ProliferationMetabolic activities are often accompanied by cell-cycle progression, yet known connections between these two processes remain limited. Here, we identified the isocitrate dehydrogenase 3β (IDH3β) as a novel substrate of anaphase-promoting complex/cyclosome (APC/C)-CDH1 and an important regulator of the cell cycle. In esophageal squamous cell carcinoma (ESCC), IDH3β was posttranslationally...
Αλέξανδρος Γ. Σφακιανάκης
45m
 Cancer Discovery current issue, Anti-BCMA CAR T-cell Therapy Reins in Myeloma [News in Brief]...
 Cancer Discovery current issue,Anti-BCMA CAR T-cell Therapy Reins in Myeloma [News in Brief]Autologous immune cells genetically engineered to target B-cell maturation antigen can help patients with relapsed or refractory multiple myeloma achieve deep molecular remissions with minimal neurotoxicity, according to initial data from a phase I trial.Cancer Discovery current issue10:05Lymphoma Chemotherapy: Hungry Macrophages Strike the Final Blow [In the Spotlight]Summary:Macrophages modulate tumor response...
Αλέξανδρος Γ. Σφακιανάκης
45m
 Cancer, Patient‐reported sexual quality of life after different types of radical prostatectomy...
 Cancer,Patient‐reported sexual quality of life after different types of radical prostatectomy and radiotherapy: Analysis of a population‐based prospective cohortBackground Although patients with prostate cancer face many treatment options, to the authors' knowledge the comparative effects of different surgical and radiotherapy (RT) options on sexual function are unclear. Methods In the current study, a population‐based cohort of 835 men with newly diagnosed prostate cancer from 2011 through 2013...
Αλέξανδρος Γ. Σφακιανάκης
46m
The Correlation Analysis of Intralabyrinthine Hemorrhage Magnetic Resonance Imaging with Hearing Loss...
The Correlation Analysis of Intralabyrinthine Hemorrhage Magnetic Resonance Imaging with Hearing Loss and Prognosis:A Retrospective Analysis of 207 casesJinye Li  Mingming Wang  Lixin Sun  Hui Zhao  Gesheng Song  Jing Tian  Na Hu  Min Li  Weiqiang Dou Jianxun Qu  Haibo Wang  Ruozhen GongFirst published: 26 June 2019 https://doi.org/10.1111/coa.13397This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading...
Αλέξανδρος Γ. Σφακιανάκης
48m
Functional relevance of Computational Fluid Dynamics in the field of nasal obstruction: a literature...
Functional relevance of Computational Fluid Dynamics in the field of nasal obstruction: a literature reviewThomas Radulesco  Lionel Meister  Gilles Bouchet  Jérôme Giordano  Patrick Dessi  Pierre Perrier Justin MichelFirst published: 24 June 2019 https://doi.org/10.1111/coa.13396This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version...
Αλέξανδρος Γ. Σφακιανάκης
48m
The Management of Suspected or Confirmed Laryngopharyngeal Reflux Patients with recalcitrant Symptoms:...
The Management of Suspected or Confirmed Laryngopharyngeal Reflux Patients with recalcitrant Symptoms: A Contemporary ReviewJérôme R. Lechien  Vinciane Muls  Giovanni Dapri  François Mouawad  Pierre Eisendrath  Antonio Schindler  Andrea Nacci  Maria Rosaria Barillari  Camille Finck  Sven Saussez … See all authorsFirst published: 23 June 2019 https://doi.org/10.1111/coa.13395This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting,...
Αλέξανδρος Γ. Σφακιανάκης
48m
Evolving management strategies in head and neck paragangliomas: A single‐centre experience with 147...
Evolving management strategies in head and neck paragangliomas: A single‐centre experience with 147 patients over a 60‐year periodJ.A. Rijken  B. de Vos  L.P. van Hest  K.M.A. Dreijerink  M. den Heijer  W. Wisselink  G.J. Blom  E.F. Hensen  C.R. LeemansFirst published: 24 May 2019 https://doi.org/10.1111/coa.13380The material in this manuscript is original research, has not been previously published and has not been submitted for publication elsewhere.The copyright line for this article was changed...
Αλέξανδρος Γ. Σφακιανάκης
49m
Avicenna Journal of Medicine
Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi ArabiaAbdulaziz Alobaid, Samer Ahmeed, Mohammed Abuzaid, Latifa Aldakhil, Ahmed Abu-ZaidAvicenna Journal of Medicine 2019 9(3):89-93Objective: To report our single-center experience in terms of patient clinical characteristics, treatment outcomes, and chemotherapy-related toxicities in patients with low-risk gestational trophoblastic neoplasia (GTN). Materials and Methods: A retrospective cross-sectional study (2008–2013)...
Αλέξανδρος Γ. Σφακιανάκης
54m
Homoeopathy
Improving validity and reliability of homoeopathyRaj Kumar ManchandaIndian Journal of Research in Homoeopathy 2019 13(2):69-71Retrospective estimation of prevalence and likelihood ratio of general symptoms of 29 less frequently prescribed homoeopathic medicines by clinical verificationRaj K Manchanda, Parthasarathi Chakraborty, Munmun Koley, Dinesh Singh, Pramodji Singh, Ojit Singh, Varanasi Gayatri Prasad, Jai Prakash Singh, Surinder Singh Nain, Prasant Kumar Pradhan, Sunil S Ramteke, Ramesh Bawaskar,...
Αλέξανδρος Γ. Σφακιανάκης
55m
Periodontology
Periodontal health: A welcome additionAshish KumarJournal of Indian Society of Periodontology 2019 23(4):297-298Indian Society of Periodontology: The pillar of periodonticsAnil MelathJournal of Indian Society of Periodontology 2019 23(4):299-300Are we addressing the core issues through bridge course?Abhay KolteJournal of Indian Society of Periodontology 2019 23(4):301-302Effect of scaling and root planing as monotherapy on glycemic control in patients of Type 2 diabetes with chronic periodontitis:...
Αλέξανδρος Γ. Σφακιανάκης
56m

Avicenna Journal of Medicine

Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi Arabia
Abdulaziz Alobaid, Samer Ahmeed, Mohammed Abuzaid, Latifa Aldakhil, Ahmed Abu-Zaid

Avicenna Journal of Medicine 2019 9(3):89-93

Objective: To report our single-center experience in terms of patient clinical characteristics, treatment outcomes, and chemotherapy-related toxicities in patients with low-risk gestational trophoblastic neoplasia (GTN). Materials and Methods: A retrospective cross-sectional study (2008&#8211;2013) was conducted at a tertiary health-care hospital in Saudi Arabia. Forty-four (n &#61; 44) patients met the inclusion criteria for low-risk GTN. Methotrexate (MTX) was administered in a 5-day regimen: 0.3&#8211;0.5mg/kg intravenously (IV) daily for 5 days every 2 weeks (maximum 25mg per dose). Actinomycin D (ActD) was administered 1.25mg/m2 pulsed IV every 2 weeks. Results: The majority of patients had molar pregnancy as the antecedent event (86&#37;), developed GTN within the first 4 months after the initial evacuation (93.2&#37;), had human chorionic gonadotropin levels between 1,000 and 10,000 mIU/dL (36.3&#37;), and had the World Health Organization prognostic scores from 0 to 2 (48.7&#37;). Only 38 patients accepted treatment with chemotherapy. A total of 37 patients received first-line MTX; 34 patients of them achieved complete remission (CR, 92&#37;). The three patients who developed MTX resistance were salvaged with sequential ActD and all achieved CR of 100&#37;. Only one patient received first-line ActD and achieved CR. The overall survival as well as cure rate for all patients with low-risk GTN was 100&#37;. No patient developed MTX-related hepatic toxicity or ActD-related blister formation. No severe adverse effects occurred. Conclusion: Our 5-day IV MTX regimen was highly effective in treating patients with low-risk GTN, with CR rate of 92&#37; and no severe toxicity. Primary and sequential ActD therapy appears to be very effective.


Women's health in Northwestern Syria: Findings from Healthy-Syria 2017 study
Abdullah Sulieman Terkawi, Basil Bakri, Amena S Alsadek, Rawaa H Alsibaee, Esraa M Alasfar, Amna H Albakour, Abdulhannan Y Aljouja, Nour A Alshaikhwais, Feras A Fares, Pamela D Flood, Hussam Jnaid, Amina A Najib, Diaa A Saloom, Noran A Zahra, Khalid A Altirkawi

Avicenna Journal of Medicine 2019 9(3):94-106

Objectives: Since the uprising in 2011, there have been limited health-care data from inside Syria regarding women&#8217;s health. This study aimed to provide an updated account of women&#8217;s health, including pregnancy, perinatal care, childbirth, and other conditions to identify obstacles and challenges to health-care delivery in Northwestern Syria. Methods: This is a prospective data registry study, using a medical electronic records system that builds on the International Classification of Diseases, Tenth Revision (ICD-10) codes. We collected data from one medical center in Northwestern Syria during 2017. We conducted a survey to understand patients&#8217; knowledge of and barriers limiting antenatal care (ANC). Results: We studied 7213 patients&#8217; health status and surveyed 134 regarding ANC. Prenatal care, delivery, and miscarriage treatment represented the most common (70&#37;) reasons for women&#8217;s health-care visits, followed by menstrual disorders (17&#37;). From 2057 delivery records, 70&#37; delivered vaginally and 30&#37; required cesarean delivery. Our findings showed that 1169 (24&#37;) of the pregnant women (4936) in 2017 were adolescents, of them 22 (0.44&#37;) were 14 years old. Regarding ANC visits, 85&#37; of respondents did not have a single ANC visit in the first trimester, 82&#37; had no visits in the second trimester, and 44&#37; had no visits in the third trimester. Thirty-one percent had no ANC visit throughout the entire pregnancy. Only 13&#37; had postnatal care (PNC) visits. Women who live in the refugee camp are 2.7 times less likely to meet the World Health Organization (WHO) criteria for focused ANC (FANC &#61; 4 visits) compared to those who reside in town (P &#0060; 0.001), with only 14&#37; having met the FANC. The major barrier to ANC is related to transportation (34&#37;), followed by factors related to the study center (29&#37;) and knowledge and education (19&#37;). We estimated the number of obstetrics-gynecology doctors per 1000 populations to be 0.02. Conclusions: We found a huge deficiency in ANC and PNC visits, a high adolescent birth rate, and a higher cesarean-to-vaginal delivery ratio than what is recommended by the WHO. We also found a severe shortage in the number of obstetrician-gynecologists serving this population.


Overprescription of antibiotics in patients with community-acquired pneumonia in the intensive care unit
Rorak Hooten, Jose Luis Marquez, Kady Goldlist, Rafael Urcis, Matthew Adams, Kathryn R Matthias, David E Nix, Mayar Al Mohajer

Avicenna Journal of Medicine 2019 9(3):107-110

Purpose: We aimed to assess factors associated with therapy failure in patients with community-acquired pneumonia in the intensive care unit (ICU). Methods: Electronic charts of patients with International Classification of Diseases, Ninth Revision, codes of pneumonia who were admitted to the ICU at a tertiary academic medical center in Southern Arizona were reviewed. Results: Antipseudomonal coverage and anti-methicillin-resistant Staphylococcus aureus (MRSA) coverage were often prescribed (58.4&#37; and 54.1&#37;, respectively). Antipseudomonal coverage was rarely necessary as pseudomonal pneumonia was found in only one case (0.9&#37;). Antipseudomonal and anti-MRSA coverage was not associated with improved outcomes. Conclusion: Overprescription of antibiotics in this population remains a significant problem. More work is needed to further limit unnecessary antibiotic use.


Sweet hydrothorax: a common presentation of a rare condition
Mohamad Alhoda Mohamad Alahmad, Rahil Kasmani

Avicenna Journal of Medicine 2019 9(3):111-114

Sweet hydrothorax is a known, yet rare, complication of peritoneal dialysis. It can be life-threatening. This case is about a 70-year-old lady who presented with acute respiratory failure due to massive right-sided hydrothorax that developed insidiously over 3 months of starting peritoneal dialysis. Thoracentesis and technetium scan confirmed the diagnosis. Treatment was successful with hemodialysis.


Late presentation of anomalous left coronary artery arising from pulmonary artery with acute coronary syndrome
Monika Bhandari, Pravesh Vishwakarma, Akshyaya Pradhan, Rishi Sethi

Avicenna Journal of Medicine 2019 9(3):115-118

Congenital anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is associated with early infant mortality and adult sudden death. The use of advanced cardiac imaging has resulted in an increase in the number of diagnosed ALCAPA cases, especially in the adult population, sometimes even asymptomatic. The extent of collateral circulation that develops between the right coronary artery (RCA) and left coronary artery (LCA) determines the outcomes. We present a case of hitherto undiagnosed case of ALCAPA, with first presentation as acute coronary syndrome (ACS) in young male.


Focal seizure as a manifestation of serotonin syndrome: case report
Eyad Almallouhi, Mohamad Rahwan, Helen Dainton, Leonardo Bonilha

Avicenna Journal of Medicine 2019 9(3):119-121

Serotonin syndrome is a life-threatening condition. Seizure is one of the complications of serotonin syndrome that may delay diagnosis and complicate management. We report a patient who had a focal seizure with abnormal electroencephalogram in the setting of serotonin syndrome with no prior history of epilepsy or seizure-provoking factors (fever, electrolyte abnormalities, specific medication combinations, and specific medication overdosing). Recognition of seizure as a symptom of serotonin syndrome is important for early treatment and avoidance of long-term consequences. Treatment of serotonin syndrome is mostly supportive. However, a short course of antiepileptics may be needed if these patients develop seizures.


Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Homoeopathy

Improving validity and reliability of homoeopathy
Raj Kumar Manchanda

Indian Journal of Research in Homoeopathy 2019 13(2):69-71



Retrospective estimation of prevalence and likelihood ratio of general symptoms of 29 less frequently prescribed homoeopathic medicines by clinical verification
Raj K Manchanda, Parthasarathi Chakraborty, Munmun Koley, Dinesh Singh, Pramodji Singh, Ojit Singh, Varanasi Gayatri Prasad, Jai Prakash Singh, Surinder Singh Nain, Prasant Kumar Pradhan, Sunil S Ramteke, Ramesh Bawaskar, Lipi Pushpa Debata, Subhranil Saha, Chaturbhuja Nayak, Lex Rutten

Indian Journal of Research in Homoeopathy 2019 13(2):72-80

Context: Scientific assessment of proving symptoms or already recorded symptoms in patients refers to Clinical Verification (CV). There are serious shortcomings of existing methods of CV, mostly arising from qualitative observations made on absolute occurrence of symptoms instead of relative ones. This problem can be resolved by the use of the Likelihood Ratio (LR). Aim: This study aims to estimate the prevalence and LRs of general symptoms of 29 less frequently prescribed homoeopathic medicines. Methods: The study was multicentric, open and observational. Patients were enrolled as per pre-specified eligibility criteria. Alongside, presenting complaints and general symptoms were taken into account during prescription. Medicines were prescribed in centesimal potencies. LR calculation of general symptoms was based on clinician-rated outcomes as &#39;improved&#39; and &#39;not improved&#39; of presenting complaints and was divided into three sections: (1) when the prevalence of a symptom was available from literature, LR was calculated by assessing the prevalence of that symptom in the responder sample, (2) in the absence of so, calculation was restricted to mean prevalence data from study sample (&#39;confined LR&#39;) and (3) &#39;confined LRs&#39; were not calculated for symptoms whose prevalence were not recorded for at least five medicines and were kept for estimation in future. Results: Of 166 general symptoms of 29 medicines, LRs and confined LRs &#62;1.5 were elicited for 6 and 49 symptoms, respectively. Conclusion: In spite of considerable caveats, it is the first insight into prevalence and LRs of general symptoms of less frequently prescribed homoeopathic medicines. Further research is warranted. 


The role of homoeopathic treatment in women suffering from post-caesarean backache: An open observational clinical trial
Arunava Nath, Mahadeb De, Subhas Singh, Nivedita Kundu, James Michael, Satarupa Sadhukhan, Deepak Kumar, Munmun Koley, Subhranil Saha

Indian Journal of Research in Homoeopathy 2019 13(2):81-90

Context: An open observational trial was carried out at National Institute of Homoeopathy, India, to assess the possible effects of individualised Homoeopathy in individuals suffering from post-caesarean backache. Aim: The aim of the study was to find the role of homoeopathic treatment in individuals suffering from post-caesarean backache. Methods: Fifty subjects were enrolled. The Short-Form McGill Pain Questionnaire (SF-MPQ) and Oswestry Low Back Pain Disability Questionnaire (ODQ) were used as the outcome measures, assessed at baseline and after 3 months of treatment. Medicines prescribed followed homoeopathic principles. Non-parametric Wilcoxon signed rank test was applied to compare the dependent observations. P &#60; 0.05 two-tailed was considered statistically significant. Results: Five subjects dropped out and 45 completed the trial. Intention-to-treat sample (n &#61; 50) was analysed. There were statistically significant reductions in pain rating index percentage score (median 83.3 (IQR 66.7 to 100) vs. median 66.7 (IQR 33.3 to 71.1), P &#60; 0.001); visual analogue scale score (median 7.0 (IQR 6.0 to 8.0) vs. median 6.0 (IQR 4.8 to 7.0), P &#60; 0.001); present pain index score (median 3.0 (IQR 2.0 to 3.0) vs. median 2.0 (IQR 2.0 to 3.0), P &#61; 0.019) and ODQ&#37; score (median 44.0 (IQR 39.5 to 50.0) vs. median 39.0 (IQR 31.9 to 44.0), P &#60; 0.001) over 3 months of treatment. Natrum muriaticum (n &#61; 11, 22&#37;); Staphysagria (n &#61; 8, 16&#37;); Bryonia alba and Rhus toxicodendron (n &#61; 6 each, 12&#37;) and Pulsatilla nigricans (n &#61; 4, 8&#37;) were prescribed frequently. Conclusion: Indicated homoeopathic medicines reduced SF-MPQ and ODQ scores. Further randomised trials are warranted with enhanced methodological rigour. 


Pharmacognostic and physicochemical study of Urtica urens L.: A drug used in Homoeopathy
Satish Patel, Bibaswan Biswas, K Rambabu, Shyaga Jhansi, Ramchander Potu, EN Sundaram, Renu Arya

Indian Journal of Research in Homoeopathy 2019 13(2):91-99

Background: Urtica urens L. (Family Urticaceae), known as annual nettle, dwarf nettle, small nettle, dog nettle or burning nettle, is used in the treatment of arthritis, uric acid diseases, benign prostatic hyperplasia and burn. In Homoeopathy, the whole plant is used for the treatment of gout, uric acid diathesis, joint pain, lithiasis, urticaria and agalactia and burns. Objective: The objectives of the present study were to investigate morpho-anatomical, powder and physicochemical standards of the whole plant of Urtica urens for authentication and identification of raw drug. Materials and Methods: The current study includes macroscopical and microscopical study of root, stem, leaf and powder and physicochemical studies of whole plant powder and mother tincture of Urtica urens. Results: The taproot is rounded, thick and brown; leaves are long petiolate, elliptic to broadly ovate; stem 0.5&#8211;1 cm thick, rounded and branched. Qualitative and quantitative microscopic studies showed the distinguishing characters of root stem and leaf. In physicochemical studies of the drug, extractive values in alcohol and water were &#8804;7.52 and &#8804;13.88&#37; w/w, respectively; loss on drying, total, acid insoluble and water-soluble ash were found to be &#8804;11.75, &#8804;24.55, &#8804;3.59 and &#8804;6.89&#37; w/w, respectively. In mother tincture, weight per millilitre, alcohol content, total solids, pH and &#955;max were found to be &#8805;0.97 g, 47&#37; v/v&#8211;52&#37; v/v, &#8804;1.88&#37; w/v, 7.93 and 266, 279 nm, respectively. Conclusion: The data presented in this communication may be used as diagnostic characters for identification and authentication of raw drug so as to ensure purity, quality and efficacy of homoeopathic drug Urtica urens. 


Evaluation of antibacterial and antioxidant potential of some homoeopathic mother tinctures
Tayyeba Rehman, Saeed Ahmad

Indian Journal of Research in Homoeopathy 2019 13(2):100-106

Objectives: In homoeopathic system of medicine, mother tinctures are prescribed for several diseases especially for septic conditions and cure of many illnesses. This study was done to evaluate the antibacterial and antioxidant potential of ten commonly used homoeopathic mother tinctures. Materials and Methods: Ten prepared mother tinctures were tested against five clinically important human pathogenic bacteria (Salmonella typhi [S.T], Escherichia coli [E.C], Bacillus subtilis [B.S], Staphylococcus aureus [S.A], and Pseudomonas aeruginosa [P.A]) by broth micro-dilution method with ciprofloxacin as positive control. Antioxidant activity was estimated by 2,2-diphenyl 1-picryl hydrazyl (DPPH) inhibition assay. Ascorbic acid was taken as positive standard in antioxidant activity. Results: All mother tinctures showed more or less antibacterial activity. Cinchona officinalis had maximum activity (89&#37; inhibition) against Salmonella typhi than all the tested mother tinctures. Pulsatilla nigricans showed the highest inhibition of DPPH (85&#37;) among other tested plant mother tinctures. Conclusion: This study reveals that the above-tested mother tincture has antibacterial and antioxidant potential against the particular microorganism and 2,2- diphenyl 1-picrylhydrazyl (DPHH), respectively. 


Attenuation of Complete Freund's Adjuvant-induced arthritis by different dilutions of Eupatorium perfoliatum and Crotalus horridus and their safety evaluation
Surender Singh, Ritu Karwasra, Prerna Kalra, Debadatta Nayak, Anil K Khurana, Raj K Manchanda

Indian Journal of Research in Homoeopathy 2019 13(2):107-117

Objective: The aim of this study was to investigate, the inhibitory effect of the homoeopathic drugs &#8211; Eupatorium perfoliatum and Crotalus horridus in experimental models of inflammation and Complete Freund&#39;s Adjuvant (CFA)-induced arthritis with evaluation of their safety aspects by acute and subacute toxicity studies. Materials and Methods: Animals were divided into eight groups (n &#61; 6). Eupatorium perfoliatum and Crotalus horridus in different dilutions (6CH, 12CH, 30CH and 200CH) were administered orally, daily during the study period of 21 days, and their effect on joint dysfunction was evaluated by measuring joint diameter in CFA-induced arthritis model. In addition, inflammatory profiles of these homoeopathic drugs were screened in carrageenan-induced paw oedema model. Acute and subacute studies were carried out according to Organization for Economic Cooperation and Development 425, 407 guidelines. The subacute toxicity study was carried out for a duration of 28 days, and all the animals were observed for behavioural abnormalities. At the end of 28th day, animals were sacrificed to carry out the biochemical, haematological and histopathological estimations. Results: Findings of the study revealed that on CFA administration, there is a significant (P &#60; 0.01) increase in joint diameter in all the tested animals. Maximum increase in joint diameter was observed on day 3 in all the treatment groups. Eupatorium perfoliatum 200CH showed significant decrease in joint diameter on day 21. In carrageenan study, the homoeopathic drugs produced a significant reduction in paw oedema at 5-h post-carrageenan administration. Study noted that the anti-inflammatory activity of Eupatorium perfoliatum was found to be superior to Crotalus horridus. Conclusion: Study inferred that Eupatorium perfoliatum and Crotalus horridus are safe at dilutions 6CH, 12CH, 30CH and 200CH and effective in minimising inflammation and arthritis in CFA-induced model. 


Protocol for efficacy of individualised homoeopathic medicine in cases of wrist ganglion: A prospective, parallel arm, randomised, double-blind, placebo-controlled trial
Central Council for Research in Homoeopathy 

Indian Journal of Research in Homoeopathy 2019 13(2):118-124

Background and Objectives: Wrist ganglia are benign soft-tissue tumours of controversial pathogenesis. Most of them are asymptomatic besides swelling but may be associated with pain, interference with activities and an increase in size. Non-surgical management options are not much effective, and surgical excision may invite complications as well as longer recovery period. Homoeopathic treatment remains a very effective measure, but the documentation of it is not adequate. This protocol is designed to evaluate the effect of individualised homoeopathic medicines in cases of wrist ganglion. Materials and Methods: The study will be a prospective, parallel arm, randomised, double-blind, placebo-controlled trial. Participants (n &#61; 154) will be allocated to individualised homoeopathic medicine group or placebo group by block randomisation. Enrolment will be done for 6 months, and every enrolled participant will be followed up for 8 months. Primary outcome measure will be changes in ganglion size at 8th month. Secondary outcome measures will be changes in pain visual analog scale score and patient-rated wrist evaluation score at every month till 8th month. Discussion: The study may help in generating evidences which may be helpful to validate the effectiveness of individualised homoeopathic medicine in the wrist ganglion. 


Case of lumbar spondylosis treated with Homoeopathic medicine Calcarea fluorica
Ranjit Sonny

Indian Journal of Research in Homoeopathy 2019 13(2):125-130

Chronic Low Back Pain (CLBP) is one of the most common problems with which people of all age groups report to physicians. It is a very troublesome complaint affecting day-to-day life, leading to decreased productivity. Amongst all the causes, lumbar spondylosis is one of the major causes of CLBP. Lumbar spondylosis commonly affects middle to later age groups. This case report describes patient with symptoms of recurrent pain in low back for the last 10 years. X-ray of the lumbosacral (L.S.) spine showed features of osteophyte confirming the diagnosis of lumbar spondylosis. After careful case-taking, homoeopathic medicine Calcarea fluorica in different potencies was prescribed as per homoeopathic principles with ever-increasing improvement. Pain in the low back gradually diminished. Ultimately, the patient got rid of all the symptoms with general improvement. After that, he was on placebo for 5 months. X-ray of the L.S spine done after treatment revealed no feature of lumbar spondylosis along with remission of osteophyte. 


Research Highlights
Daisy Katarmal

Indian Journal of Research in Homoeopathy 2019 13(2):131-134



Book review: Prognostic factor research in Homoeopathy
Laxmikanta Nanda

Indian Journal of Research in Homoeopathy 2019 13(2):135-136



Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Periodontology

Periodontal health: A welcome addition
Ashish Kumar

Journal of Indian Society of Periodontology 2019 23(4):297-298



Indian Society of Periodontology: The pillar of periodontics
Anil Melath

Journal of Indian Society of Periodontology 2019 23(4):299-300



Are we addressing the core issues through bridge course?
Abhay Kolte

Journal of Indian Society of Periodontology 2019 23(4):301-302



Effect of scaling and root planing as monotherapy on glycemic control in patients of Type 2 diabetes with chronic periodontitis: A systematic review and meta-analysis
Akanksha Jain, Jyoti Gupta, Dipika Bansal, Shaveta Sood, Shipra Gupta, Ashish Jain

Journal of Indian Society of Periodontology 2019 23(4):303-310

Background: There is enough evidence, which suggests that nonsurgical periodontal therapy (NSPT) improved the glycemic control in patients of Type 2 diabetes mellitus (T2DM) with chronic periodontitis (CP). This meta-analysis is aimed to explore the effect of NSPT, exclusively scaling and root planing (SRP) as monotherapy on glycemic control and periodontal parameters in patients of T2DM with CP. Materials and Methods: Two databases, MEDLINE and EMBASE, were searched from June 2006 to June 2016. Initially, 464 potentially relevant studies were evaluated. Randomized controlled trials with duration of &#8805;3 months, based on the treatment group managed with SRP without any supportive use of local drug delivery or systemic antibiotics, while the control group received no periodontal therapy, were selected. This resulted in six appropriate articles with a total of 812 patients of T2DM with CP. Alteration in glycated hemoglobin (HbA1c) was the primary outcome measure, whereas the changes in clinical attachment level (CAL) and probing pocket depth (PPD) were the secondary outcome measures. Results: SRP treatment resulted in a decrease in HbA1c by 0.26&#37; (P &#61; 0.17) at 3&#8211;4 months compared to the control group. Further, on subgroup analysis, SRP therapy revealed a decrease in PPD and CAL at 3&#8211;4 months, though statistically insignificant. Conclusion: SRP treatment leads to modest improvement in glycemic status and periodontal parameters in T2DM patients with CP at 3&#8211;4 months. 


Effects of recombinant human bone morphogenetic protein-2 compared to other biomaterials in the treatment of intrabony defects in periodontitis patients: A systematic review
Raghavendra Shrishail Medikeri, Vinayak Venkoosa Meharwade, Kumar Ankit Sinha

Journal of Indian Society of Periodontology 2019 23(4):311-315

Background: Bone morphogenetic proteins have a powerful osteoinductive capacity and have been used as a new adjunct to graft materials for bone regeneration. The objectives of this systematic review are to assess the amount of radiographic bone fill, clinical attachment level (CAL) gain, and reduction in pocket depth (PD) in patients with intrabony defects in periodontitis patients following the use of recombinant human bone morphogenetic protein-2 (rhBMP-2). Materials and Methods: Electronic bibliographic databases search of Medline, Science Direct, and Google Scholar was made from January 1980 to December 2017. Studies using rhBMP-2 to treat periodontal intrabony defects of the maxillary or mandibular region with follow-up period of at least 6 months were searched. Two reviewers performed the systematic review using the PRISMA Statement for reporting and the Cochrane risk-of-bias tool was used for quality assessment. Results: It was found that rhBMP-2 showed statistically significant results with respect to radiographic defect resolution, CAL, and PD reduction at 9 months compared to open-flap debridement but showed statistically significant results only with respect to radiographic bone fill when compared with platelet-rich fibrin at 6 months. Conclusion: The rhBMP-2 may provide a promising alternative to traditional grafting procedures therapy that can enhance periodontal regeneration in patients having intrabony defects. Due to limited human studies, it can be concluded that no definitive evidence exists to ascertain the effectiveness of rhBMP-2 in the treatment of intrabony defects in periodontal diseases. 


Estimation of phagocytic activity of polymorphonuclear leukocytes in chronic and aggressive periodontitis patients with nitroblue tetrazolium test
Jagadish Reddy Gooty, Andem Shashirekha, Vikram Reddy Guntakala, Rajababu Palaparthi

Journal of Indian Society of Periodontology 2019 23(4):316-321

Context: The phagocytic activity of polymorphonuclear leukocytes (PMN) is influenced by the type of disease entity, i.e., chronic generalized periodontitis, generalized aggressive periodontitis, and chronic generalized gingivitis. Aims: The purpose of this experimental study was to evaluate the phagocytic activity of PMN in patients with chronic generalized periodontitis, generalized aggressive periodontitis, and chronic generalized gingivitis. Materials and Methods: A total of 60 patients, 20 patients with chronic generalized periodontitis, 20 patients with generalized aggressive periodontitis, and 20 patients with chronic generalized gingivitis were selected for this study. Blood samples were collected from the patients. Peripheral smears were prepared from the samples, and the slides were stained using nitroblue tetrazolium test, and the phagocytic activity of the neutrophils was compared using the test results. Statistical Analysis Used: Intragroup comparison using Mann&#8211;Whitney U-test and intergroup comparison using Kruskal&#8211;Wallis one-way ANOVA test were done. Results: The results of the present study suggest that PMN phagocytic defect was present in most of the patients affected by generalized aggressive periodontitis; however, the phagocytic defect cannot be attributed to age, sex, or clinical parameters such as the plaque index or gingival index and probing pocket depths. Conclusions: The phagocytic activity of neutrophils in generalized aggressive periodontitis was low compared to chronic generalized periodontitis and chronic generalized gingivitis. 


Comparative evaluation of growth factors from platelet concentrates: An in vitro study
Anirban Chatterjee, Koel Debnath

Journal of Indian Society of Periodontology 2019 23(4):322-328

Aim: The aim of the study was to compare and evaluate the various growth factors released for a period of 23 days from platelet rich fibrin (PRF) and platelet rich fibrin matrix (PRFM). Materials and Methods: A total of 15 systemically healthy controls were recruited and 10 ml of blood sample was withdrawn from the individual. Following the standard centrifugation protocol, PRF and PRFM were prepared. The platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), fibroblast growth factor (FGF), transforming growth factor (TGF), and insulin growth factor (IGF) were evaluated for 23 days. Results: The PDGF released from PRFM was statistically significant from PRF till the 15th day of release. The VEGF too had an increased release up till the 15th day from PRFM group as compared to PRF, but no statistically significant difference could be obtained. EGF from the 15th day to 23rd day had a greater release from PRFM group as compared to PRF group. FGF from 7th day to 23rd day had statistically significant difference in the PRFM group as compared to PRF group. TGF and IGF had statistically significant difference in PRFM group as compared to PRF group from 11th day to 23rd day and 1st to 17th day, respectively. Conclusion: The initial and robust release of GFs was seen in PRFM group at earlier days, whereas a steady and constant release of six GFs could be appreciated from PRF group upto 23rd day. Therefore, for a rapid and early healing and regeneration, both the platelet concentrates can be utilized in periodontal therapy. 


Assessment of membrane-organizing extension spike protein as a biomarker for periodontal disease by comparing its level in gingival crevicular fluid in individuals with and without chronic severe periodontitis – A pilot study
Anjali Sreedharan, Mohammed Shereef, Jayachandran Perayil, Angel Fenol, Rajesh Vyloppillil, Biju Balakrishnan

Journal of Indian Society of Periodontology 2019 23(4):329-333

Background: Membrane-organizing extension spike protein (Moesin) is a cytoskeletal protein expressed in the gingival crevicular fluid (GCF) which may play a role in the immune response in periodontal disease. The objective of this study was to evaluate whether Moesin can be used as a biomarker for periodontal disease. Materials and Methods: Thirty patients satisfying the required inclusion criteria were selected from those reporting to the out patient (OP) of the department of periodontics and divided into two groups: Group A &#8211; systemically healthy controls with no periodontitis and Group B &#8211; systemically healthy controls with chronic severe periodontitis. Periodontal parameters were recorded. GCF was collected, and Moesin levels in the two groups were assessed using enzyme-linked immunosorbent assay. Scaling and root planing (SRP) was done in Group B patients who were reviewed, and samples were collected again after 4 weeks and analyzed. Results: At baseline, the mean GCF Moesin level in Group A was 666.95 &#177; 471.872 pg/ml, while in Group B, it was found to be 27435.35 &#177; 14179.77 pg/ml, which showed a high statistically significant difference on comparison. The mean GCF Moesin level in patients with chronic severe periodontitis was 27435.35 &#177; 14179.77 pg/ml at baseline, and on review 1 month after SRP, it was found to have undergone a statistically significant reduction to 27161.23 &#177; 14161.57 pg/ml (P &#61; 0.001). Conclusion: Within the limits of this study, it can be concluded that Moesin can serve as a potential biomarker for periodontal disease. 


Evaluation of the cone-beam computed tomography accuracy in measuring soft tissue thickness in different areas of the jaws
Ehsan Moudi, Sina Haghanifar, Maryam Johari, Hemmat Gholinia, Mohammad Kazemi Ghanbarabadi

Journal of Indian Society of Periodontology 2019 23(4):334-338

Purpose: Due to the extensive use of cone-beam computed tomography (CBCT) in dentistry, especially in measuring thicknesses of hard and soft tissues, and the fact that CBCT has low contrast resolution, the aim of this study was to evaluate the accuracy of CBCT in measuring soft tissue thickness. Materials and Methods: In this cross-sectional study, pink baseplate wax as a soft tissue simulation was overlaid in different areas of the jaws on the dry human skull, and the probe was used to determine the thicknesses of 1, 2, 3, and 5 mm. These thicknesses were then measured accurately with a digital caliper by one person four times at interval of a week. The skull was scanned using two CBCT scanners, and the different thicknesses of wax were measured by two observers four times with a week interval. The CBCT measurements were compared with digital caliper measurements as a reference. Results: Statistical analysis showed no significant difference between CBCT and digital caliper measurements for thickness <2 mm (P &#62; 0.05). Conclusions: Statistically, the difference between digital caliper and CBCT measurements was <0.1 mm, but this difference is not clinically important. The accuracy of CBCT in measuring soft tissue thickness was 0.1 mm. 


Effects of amine fluoride and probiotic mouthwash on levels of Porphyromonas gingivalis in orthodontic patients: A randomized controlled trial
Neeraj Goyal, Pavithra Untagodu Shamanna, Sanju Thomas Varughese, Reji Abraham, Bobby Antony, Rishi Emmatty, Parson Paul

Journal of Indian Society of Periodontology 2019 23(4):339-344

Introduction: Porphyromonas gingivalis is one among the major etiological agent in periodontal diseases and has been proved to cause gingival inflammation under orthodontic appliances. Aim: To assess the effect of amine fluoride and probiotic mouthwashes on levels of P. gingivalis during orthodontic treatment, using real time-polymerase chain reaction (RT-PCR). Materials and Methods: A randomised controlled trial was performed including 45 patients. There were three groups: Group A (control group), Group B (patients using Amflor mouthwash) and Group C (patients using probiotic mouthwash). During the treatment, all the 3 groups were advised to brush twice a day using Colgate tooth paste and Group B patients were advised to swish 15 ml fluoridated mouthwash (Amflor) and Group C advised to swish probiotic for 60 s before swallowing, once in the morning and once before sleep. After gently removing supragingival plaque, subgingival plaque samples were collected by inserting a sterile dental curette into the bottom of the gingival crevice around 31, 32, 41, and 42 at two different intervals: T1 at start and T2 after 6 months of fixed orthodontic treatment. Sub-gingival plaque samples collected were transferred to laboratory within 48 h for RT-PCR analysis in Tris-buffer solution, to maintain the integrity of bacterial DNA. Results: The levels of P. gingivalis were significantly decreased with probiotic mouth wash. Conclusions: Probiotic mouth wash can be used as an adjunctive measure along with regular brushing to improve periodontal status during fixed orthodontic treatment. 


Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480