Objective:
To investigate the association of cognitive impairment (COGI) and depression with all-cause mortality and cardiovascular-specific mortality among community-dwelling elderly individuals in ...rural Greece.
Methods:
Cognition and depressive symptomatology of 676 Velestino town residents aged ≥60 years were assessed using Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS), respectively. Eight-year all-cause mortality and cardiovascular mortality were explored by multivariate Cox regression models controlling for major confounders.
Results:
Two hundred and one patients died during follow-up. Cognitive impairment (MMSE ≤ 23) was independently associated with all-cause mortality (hazard ratio HR: 1.57, 95% confidence interval CI: 1.13-2.18) and cardiovascular mortality (HR: 1.57, 95%CI: 1.03-2.41). Moderate to severe depression (GDS > 10) was significantly associated only with a 51% increase in all-cause mortality. A male-specific association was noted for moderate to severe depression, whereas the effect of COGI was limited to females. Noteworthy, COGI and depression comorbidity, rather than their sole presence, increased all-cause mortality and cardiovascular mortality by 66% and 72%, respectively. The mortality effect of COGI was augmented among patients with depression and of depression among patients with COGI.
Conclusion:
COGI and depression, 2 entities often coexisting among elderly individuals, appear to increase all-cause mortality and cardiovascular mortality. Gender-specific modes may prevail but their comorbidity should be carefully assessed, as it seems to represent an independent index of increased frailty, which eventually shortens life expectancy.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
The well-studied role of epidermal growth factor receptor (EGFR) in metastatic colorectal cancer (mCRC) and non-small cell lung cancer (NSCLC) has enabled the development of drugs that target this ...molecule, including panitumumab for the former and osimertinib for the latter. Oral adverse events due to those agents are rarely described in the literature and their exact characterization is hampered by inadequate reporting and/or incorrect terminology used. We report two cases of panitumumab- and osimertinib-associated oral ulcerations with emphasis on their possible pathogenesis and optimal management.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
IMPORTANCE: Estrogens have neuroprotective and antidepressive effects; however, associations between indices of reduced endogenous estrogens and risk for postmenopausal depression have not been ...systematically explored. OBJECTIVE: To investigate the association of age at menopause and the duration of the reproductive period with the risk for depression among postmenopausal women with naturally occurring menopause. DATA SOURCES: A search strategy for use of MEDLINE was developed (through January 1, 2015) using the key terms menopause, climacteric, reproductive period, depression, and mood disorders. References of included studies and reviews were also screened; authors were contacted to maximize synthesized evidence. STUDY SELECTION: A total of 12 323 articles, without language restriction, were screened by pairs of reviewers to identify observational studies related to the study hypothesis; 14 studies were eligible for meta-analysis. DATA EXTRACTION AND SYNTHESIS: Pairs of reviewers independently extracted information on study design and type of analysis by participants’ characteristics and methods of depression ascertainment. Study quality was assessed using the Newcastle-Ottawa Scale, and fixed- or random-effects models were implemented. MAIN OUTCOMES AND MEASURES: Pooled-effect estimates for depression, defined by psychiatric evaluation or validated instruments, by age at menopause and duration of the reproductive period. RESULTS: The 14 studies included in the meta-analysis represented 67 714 women. An inverse association (reported as odds ratio OR; 95% CI of 2-year increments) with depression in postmenopausal women was shown for increasing age at menopause (0.98; 0.96-0.99 67 434 unique participants; 13 studies) and duration of the reproductive period (0.98; 0.96-0.99 54 715 unique participants; 5 studies). Menopause at age 40 or more years compared with premature menopause was associated with a 50% decreased risk for depression (3033 unique participants; 4 studies). Pooling of studies examining severe depression showed a 5% decrease in risk of severe depression with increasing (2-year increment) age at menopause (52 736 unique participants; 3 studies); sensitivity analysis of studies controlling for past depression revealed similar results for age at menopause (0.98; 0.96-1.00 48 894 unique participants; 3 studies). No heterogeneity or publication bias was evident in the main analyses. CONCLUSIONS AND RELEVANCE: Longer exposure to endogenous estrogens, expressed as older age at menopause and longer reproductive period, is associated with a lower risk of depression in later life. Identifying women at higher risk for depression due to early menopause who could benefit from psychiatric intervention or estrogen-based therapies could be useful in the clinical setting.
It is widely acknowledged that emotions and cognition are closely related, and that negative emotions are detrimental on school achievement, especially on mathematical performance. On the other hand, ...positive emotions have a positive impact on motivation and cognitive abilities underlying the learning processes. Nevertheless, studies about the effects of experienced emotions on problem solving, a specific type of mathematical activity, are sparse. The present research focuses on experienced epistemic and achievement emotions after the resolution of two types of numerical word problems: the application problems, that requires the use of a specific and expected algorithm to be solved and are regularly proposed at school; and the non-application problems, which cannot be solved directly but using different solving strategies. This type of numerical word problems appears less frequently in French school curricula. In experiment 1, 105 adults (M = 24.4 years), of which the majority was university students, were involved in an online experiment with APs and NAPs problems and were asked to rate their experienced emotions after the resolution of the problems. In experiment 2, 65 children aged 9-year-old were asked to individually solve APs and NAPs problems with age-appropriate difficulty and then rate their associated emotions. The adults' sample reported higher epistemic and achievement positive emotions towards APs compared to NAPs. In both adults and children NAPs were more associated to surprise than APs. In children anxiety was more experienced after resolution of NAPs than APs. Results suggest the importance of varying the types of problems proposed in school curricula so that children become accustomed to using different solving strategies. This approach could be useful in decreasing negative emotions toward mathematics such as anxiety, which begins to settle as early as elementary school.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The role of thyroxine administration on orthodontically induced tooth movement and/or inflammatory root resorption remains unclear. The aim was to assess the influence of thyroxine administration on ...orthodontically induced tooth movement and/or inflammatory root resorption. The study protocol was registered in PROSPERO (CRD42020164151). An electronic search of indexed databases was conducted without time or language restrictions up to and including May 2020. The following eligibility criteria were imposed: (a) original prospective controlled clinical studies and/or experimental studies on animal models; (b) subjects undergoing orthodontic therapy with fixed appliances; (c) presence of a control group orthodontic tooth movement without thyroxine administration; and (d) intervention: orthodontic tooth movement with thyroxine administration. Review articles, commentaries, letters to the editor, case reports/series, studies with no control group, cross‐sectional studies, retrospective studies and studies where thyroxine was administered along with other interventions such as calcitonin and prostaglandins were excluded. Quality of available evidence and risk of bias within studies were assessed. Any disagreements were resolved via consensus discussions. Based on the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, 8 animal studies were included. Four studies reported that thyroxine administration increases the rate of orthodontic tooth movement; 3 studies did not show a significant difference. Three studies showed that thyroxine administration decreases orthodontically induced inflammatory root resorption; 2 studies found no significant difference. The risk of bias among studies was high. In conclusion, the influence of thyroxine administration on orthodontic tooth movement and/or orthodontically induced inflammatory root resorption in animal models remains unclear.
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CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Introduction
The social media attitude of health science students might affect patients' opinion about the health profession and have negative impact on e‐professionalism. The aim of this study is to ...investigate the behaviour of Greek dental students on Facebook, focusing on potentially unprofessional posts and the online student‐patient relationship.
Materials and methods
Five hundred and twelve dental students in Greece answered an anonymous, 23‐item questionnaire including multiple‐choice questions about various topics, including Facebook profile settings and content shared by dental students, student‐patient relationship via Facebook; and students' perception about the impact of their online behaviour.
Results
93.2% of responders had a Facebook profile and 80.5% admitted that their online attitude might affect patients' opinion about dental profession. However, 71.7% posted pictures from holidays, 41.5% from nightclubs, and 26.2% photographs wearing swimwear/underwear, while 12.8% expressed online political party predilection. One quarter of students in clinical years were Facebook friends with patients and 58% and 30% of them had online discussion about topics related or not to dentistry, respectively, while 6.8% of dental students had posted defamatory comments about the dental school, faculty members or academic staff on Facebook.
Discussion
In accordance with studies in other countries, most Greek dental students had a Facebook profile and, although the majority realised the impact of Facebook behaviour on e‐professionalism, a considerable percentage posted unprofessional content.
Conclusion
Dental students might fall into pitfalls when it comes to e‐professionalism. As social media are becoming an integral part of life, there is need to include e‐professionalism in dental education curriculum.
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BFBNIB, CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Objective
Oral ulceration with bone sequestration (OUBS) describes a site‐specific intraoral ulcer that covers exposed, non‐vital bone in patients lacking any etiological factor known to induce ...osteonecrosis. We aimed to conduct a retrospective study of eight new cases of OUBS and review the literature.
Subjects and Methods
This is a retrospective study of OUBS cases, diagnosed and managed during 2007–2017. Inclusion criteria were the presence of oral ulcer with exposed non‐vital bone at sites of bone prominence and the absence of any factor known to cause osteonecrosis. The English literature was reviewed on original OUBS cases.
Results
Eight patients (5 males and 3 females, aged 27–75 years) were diagnosed with OUBS during years 2007–2017. Four cases involved the mandibular mylohyoid ridge, one a mandibular anterior exostosis and three the maxillary buccal/palatal exostoses. Exposed bone was removed under local anesthesia, resulting in complete healing in all cases. The literature review yielded 32 OUBS cases in the mandible.
Conclusion
Oral ulceration with bone sequestration is a distinct, probably under‐reported rather than rare clinical entity that should be regarded the provisional diagnosis in case of an oral ulcer covering exposed, non‐vital bone at sites of bone prominence in patients lacking any etiological factor known to induce osteonecrosis.
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CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
The aim of this study was to describe 4 patients with oral mucosa hyperpigmentation associated with 4 drug classes and to review the relevant literature.
Two patients under imatinib and ...hydroxychloroquine treatment exhibited diffuse palatal hyperpigmentation and 2 patients treated with minocycline and golimumab showed multifocal pigmented macules. In all cases, biopsy was performed.
Microscopically, in all cases, there was no increase in the number of melanocytes in the epithelium, and pigment granules were present in the lamina propria. The pigment granules in minocycline- and golimumab-associated hyperpigmentation were seen in the superficial lamina propria and reacted for silver but not iron, whereas in imatinib- and hydroxychloroquine-associated hyperpigmentation, pigment granules were found in the reticular lamina propria and reacted for both silver and iron. A review of the literature found 38 cases of hyperpigmentation of the oral mucosa attributed to minocycline, 23 to imatinib, 1 to hydroxychloroquine without microscopic documentation, and none to golimumab.
The temporal relationship between pigmentation and onset of drug effect, resolution following drug withdrawal, and exclusion of other causes support the diagnosis of drug-induced hyperpigmentation. Microscopic examination may be contributory to diagnosis, as there are differences among drugs with regard to the distribution of pigment granules and the histochemical reactions of the drugs.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Oral cancer is a common malignancy worldwide, with high disease-related death rates. Oral squamous cell carcinoma (OSCC) accounts for more than 90% of oral tumors, with surgical management remaining ...the treatment of choice. However, advanced and metastatic OSCC is still incurable. Thus, emphasis has been given lately in understanding the complex role of the oral tumor microenvironment (TME) in OSCC progression, in order to identify novel prognostic biomarkers and therapeutic targets. Tumor associated macrophages (TAMs) constitute a major population of the OSCC TME, with bipolar role in disease progression depending on their activation status (M1 vs. M2). Here, we provide an up to date review of the current literature on the role of macrophages during oral oncogenesis, as well as their prognostic significance in OSCC survival and response to standard treatment regimens. Finally, we discuss novel concepts regarding the potential use of macrophages as targets for OSCC immunotherapeutics and suggest future directions in the field.
Background
Odontogenic keratocyst is characterized by local aggressive behavior and a high recurrence rate, as well as its potential to develop in association with the basal cell nevus syndrome. The ...aim of this study was to decode the gene expression program accompanying odontogenic keratocyst phenotype.
Methods
150‐bp paired‐end RNA‐sequencing was applied on six sporadic and six basal cell nevus syndrome‐associated whole‐tissue odontogenic keratocyst samples in comparison to six dental follicles, coupled with bioinformatics and complemented by immunohistochemistry.
Results
2654 and 2427 differentially expressed genes were captured to characterize the transcriptome of sporadic and basal cell nevus syndrome‐associated odontogenic keratocysts, respectively. Gene ontologies related to “epidermis/skin development” and “keratinocyte/epidermal cell differentiation” were enriched among the upregulated genes (KRT10, NCCRP1, TP63, GRHL3, SOX21), while “extracellular matrix organization” (ITGA5, LOXL2) and “odontogenesis” (MSX1, LHX8) gene ontologies were overrepresented among the downregulated genes in odontogenic keratocyst. Interestingly, upregulation of various embryonic stem cells markers (EPHA1, SCNN1A) and genes committed in cellular reprogramming (SOX2, KLF4, OVOL1, IRF6, TACSTD2, CDH1) was found in odontogenic keratocyst. These findings were highly shared between sporadic and basal cell nevus syndrome‐associated odontogenic keratocysts. Immunohistochemistry verified SOX2, KLF4, OVOL1, IRF6, TACSTD2/TROP2, CDH1/E‐cadherin, and p63 expression predominantly in the odontogenic keratocyst suprabasal epithelial layers.
Conclusion
The odontogenic keratocyst transcriptomic profile is characterized by a prominent epidermal and dental epithelial fate, a repressed dental mesenchyme fate combined with deregulated extracellular matrix organization, and enhanced stemness gene signatures. Thus, we propose a developed epidermis‐like phenotype in the odontogenic keratocyst suprabasal epithelial cells, established in parallel to a significant upregulation of marker genes related to embryonic stem cells and cellular reprogramming.
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CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
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