Identifying Characteristic Fire Properties with Stationary and Non-Stationary Fire Alarm Systems

The article reviews issues associated with the operation of stationary and non-stationary electronic fire alarm systems (FASs). These systems are employed for the fire protection of selected buildings (stationary) or to monitor vast areas, e.g., forests, airports, logistics hubs, etc. (non-stationary). An FAS is operated under various environmental conditions, indoor and outdoor, favourable or unfavourable to the operation process. Therefore, an FAS has to exhibit a reliable structure in terms of power supply and operation. To this end, the paper discusses a representative FAS monitoring a facility and presents basic tactical and technical assumptions for a non-stationary system. The authors reviewed fire detection methods in terms of fire characteristic values (FCVs) impacting detector sensors. Another part of the article focuses on false alarm causes. Assumptions behind the use of unmanned aerial vehicles (UAVs) with visible-range cameras (e.g., Aviotec) and thermal imaging were presented for non-stationary FASs. The FAS operation process model was defined and a computer simulation related to its operation was conducted. Analysing the FAS operation process in the form of models and graphs, and the conducted computer simulation enabled conclusions to be drawn. They may be applied for the design, ongoing maintenance and operation of an FAS. As part of the paper, the authors conducted a reliability analysis of a selected FAS based on the original performance tests of an actual system in operation. They formulated basic technical and tactical requirements applicable to stationary and mobile FASs detecting the so-called vast fires.

A Comprehensive Investigation of the Mechanical and Tribological Properties of AZO Transparent Conducting Oxide Thin Films Deposited by Medium Frequency Magnetron Sputtering

This paper presents a detailed analysis of aluminium-doped zinc oxide (AZO) thin films and considers them a promising alternative to indium tin oxide in transparent electrodes. The study focusses on critical properties of AZO, including optical, electrical, and mechanical properties, with potential applications in displays, photovoltaic cells, and protective coatings. The deposited AZO thin films are characterised by excellent optical and electrical parameters, with transparency in the visible light range exceeding 80% and resistivity of 10-3 Ω·cm, which gives a high value of figure of merit of 63. Structural analysis confirms the nanocrystalline nature of as-deposited AZO thin films, featuring hexagonal ZnO, orthorhombic Al2O3, and cubic Al2ZnO4 phases. The study includes nanoindentation measurements, which reveal exceptional hardness (11.4 GPa) and reduced elastic modulus (98 GPa), exceeding typical values reported in the literature, highlighting their protective potential. Abrasion tests have shown extraordinary scratch resistance due to the lack of impact on topography and surface roughness up to 10,000 cycles. This comprehensive study demonstrated that as-deposited AZO thin films are multifunctional materials with exceptional optical, electrical, and mechanical properties. The findings open up possibilities for a variety of applications, especially in protective coatings, where the combination of hardness, scratch resistance, and transparency is both rare and valuable.

Characterization of Structural, Optical, Corrosion, and Mechanical Properties of HfO2 Thin Films Deposited Using Pulsed DC Magnetron Sputtering

Various properties of HfO₂, such as hardness, corrosion, or electrical resistance, depend on the method and the conditions of deposition. In this work, a thorough comparison of scarcely investigated mechanical properties of HfO₂ thin films deposited with different conditions of reactive magnetron sputtering process is presented. Four thin films were sputtered in processes that varied in plasma ignition method (continuous or sequential) and target-substrate distance. The structural characteristics of the HfO₂ thin films were examined using Raman spectroscopy and X-ray diffraction measurements. Furthermore, the optoelectronic properties were determined based on transmittance and current-voltage characteristics. The mechanical properties of the HfO₂ thin films were determined using nanoindentation and scratch test. In turn, the corrosion properties were determined by analyzing the voltametric curves. The transparent HfO₂ thin films deposited in the continuous process are characterized by better corrosion resistance than the same layer formed in the sequential process, regardless of the target-substrate distance (8 cm or 12 cm). Furthermore, these samples are also characterized by the highest value of Young's modulus and scratch resistance. The combination of good corrosion and scratch resistance could contribute to the new application of HfO₂ as a corrosion protective material.

WO3 Thin-Film Optical Gas Sensors Based on Gasochromic Effect towards Low Hydrogen Concentrations

Hydrogen gas sensors have recently attracted increased interest due to the explosive nature of H₂ and its strategic importance in the sustainable global energy system. In this paper, the tungsten oxide thin films deposited by innovative gas impulse magnetron sputtering have been investigated in terms of their response to H₂. It was found that the most favourable annealing temperature in terms of sensor response value, as well as response and recovery times, was achieved at 673 K. This annealing process caused a change in the WO₃ cross-section morphology from a featureless and homogenous form to a rather columnar one, but still maintaining the same surface homogeneity. In addition to that, the full-phase transition from an amorphous to nanocrystalline form occurred with a crystallite size of 23 nm. It was found that the sensor response to only 25 ppm of H₂ was equal to 6.3, which is one of the best results presented in the literature so far of WO₃ optical gas sensors based on a gasochromic effect. Moreover, the results of the gasochromic effect were correlated with the changes in the extinction coefficient and the concentration of the free charge carriers, which is also a novel approach to the understanding of the gasochromic phenomenon.

Hydrogen Gas Sensing Properties of Mixed Copper-Titanium Oxide Thin Films

Hydrogen is an efficient source of clean and environmentally friendly energy. However, because it is explosive at concentrations higher than 4%, safety issues are a great concern. As its applications are extended, the need for the production of reliable monitoring systems is urgent. In this work, mixed copper-titanium oxide ((CuTi)Ox) thin films with various copper concentrations (0-100 at.%), deposited by magnetron sputtering and annealed at 473 K, were investigated as a prospective hydrogen gas sensing material. Scanning electron microscopy was applied to determine the morphology of the thin films. Their structure and chemical composition were investigated by X-ray diffraction and X-ray photoelectron spectroscopy, respectively. The prepared films were nanocrystalline mixtures of metallic copper, cuprous oxide, and titanium anatase in the bulk, whereas at the surface only cupric oxide was found. In comparison to the literature, the (CuTi)Ox thin films already showed a sensor response to hydrogen at a relatively low operating temperature of 473 K without using any extra catalyst. The best sensor response and sensitivity to hydrogen gas were found in the mixed copper-titanium oxides containing similar atomic concentrations of both metals, i.e., 41/59 and 56/44 of Cu/Ti. Most probably, this effect is related to their similar morphology and to the simultaneous presence of Cu and Cu₂O crystals in these mixed oxide films. In particular, the studies of surface oxidation state revealed that it was the same for all annealed films and consisted only of CuO. However, in view of their crystalline structure, they consisted of Cu and Cu₂O nanocrystals in the thin film volume.

Coloration mechanism in gasochromic thin films through the analysis of a complex refractive index

In this paper, the dispersion of a complex refractive index is investigated and proposed as a way to analyze the change of the optical properties of gasochromic material under the influence of diluted hydrogen (3.5% H ₂ in Ar) as an active volatile medium. Therefore, a tungsten trioxide thin film and an additional platinum catalyst were deposited by electron beam evaporation and used as a prototype material. Based on experimental verification, it is shown that the proposed method allows one to explain the reasons for the observed changes in the transparency in such materials.

Optical and structural properties of gradient (Ti,Co)Ox thin-film coatings with a resistive switching effect

In this work, the optical and structural properties of gradient (Ti,Co)Ox coatings with a resistive switching effect have been outlined. They were prepared using multi-magnetron sputtering and, despite the high cobalt content, they were transparent and had a high refractive index. The gradient Co-addition resulted in the receiving of fine crystalline T i O ₂-anatase and C o ₃ O ₄ forms in the amorphous surrounding. Observed resistance switching was a fully repeatable effect, and its occurrence in gradient (Ti,Co)Ox coatings has not reported earlier. The prepared gradient coatings exhibit great potential as transparent electronic devices with the resistance switching effect. Such memory effects in transparent thin-film coatings open new possibilities for the manufacturing of innovative memory elements in the future.

Incremental value of myocardial work in predicting beneficial response to aortic valve replacement in patients with aortic stenosis

 

The predictors of favorable clinical response to aortic valve replacement (AVR) in aortic stenosis (AS) are still insufficiently defined. The increased LV afterload in AS affects the interpretation of the majority of LV systolic indices, which are load-dependent. The estimation of myocardial work (MW) is a newly developed approach, which, allowing correction of global longitudinal strain (GLS) for LV afterload, gives a more adequate insight into the intrinsic LV contractility.

Aim

To investigate whether the assessment of MW can improve the prediction of clinical and neurohormonal improvement post AVR in patients with AS.

Methods

We evaluated 126 patients (75±9 years) with severe AS who underwent transcatheter AVR (n=100) or surgical AVR (n=26). Transthoracic echocardiography, blood sampling and 6 min walk test (6MWT) were performed pre and 3 months post AVR. The following indices of MW were assessed: global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE).

Results

Post-AVR changes in the clinical and echocardiographic profile are presented in Table. Post-treatment increase in 6MWT distance was noted in 95 patients, and decrease in NT-proBNP in 94 patients. In multivariable analysis including clinical parameters and echocardiographic indices of cardiac function, morphology and aortic valve hemodynamic, baseline GWW was the only independent echocardiographic predictor of post-AVR improvement in 6MWT distance (beta=−0.24, SE 0.09, p=0.01), whereas baseline GWE was, in addition to tricuspid regurgitation pressure gradient (TRPG) and E/e' ratio, independently associated with the post-AVR decrease in NT-proBNP (beta=0.27, SE 0.09, p=0.004).

Conclusions

In patients with severe AS undergoing AVR, higher values of GWW do not favor post-treatment functional improvement as assessed by 6MWT. The beneficial neurohormonal response to AVR is more pronounced in patients with less efficient LV contraction at baseline.

Funding Acknowledgement

Type of funding sources: None.

Investigation of the Microstructure, Optical, Electrical and Nanomechanical Properties of ZnOx Thin Films Deposited by Magnetron Sputtering

The paper presents the results of an investigation of the influence of technological parameters on the microstructure, optical, electrical and nanomechanical properties of zinc oxide coatings prepared using the pulsed reactive magnetron sputtering method. Three sets of ZnOx thin films were deposited in metallic, shallow dielectric and deep dielectric sputtering modes. Structural investigations showed that thin films deposited in the metallic mode were nanocrystalline with mixed hexagonal phases of metallic zinc and zinc oxide with crystallite size of 9.1 and 6.0 nm, respectively. On the contrary, the coatings deposited in both dielectric modes had a nanocrystalline ZnO structure with an average crystallite size smaller than 10 nm. Moreover, coatings deposited in the dielectric modes had an average transmission of 84% in the visible wavelength range, while thin films deposited in the metallic mode were opaque. Measurements of electrical properties revealed that the resistivity of as-deposited thin films was in the range of 10^-4 Ωcm to 10⁸ Ωcm. Coatings deposited in the metallic mode had the lowest hardness of 2.2 GPa and the worst scratch resistance among all sputtered coatings, whereas the best mechanical properties were obtained for the film sputtered in the deep dielectric mode. The obtained hardness of 11.5 GPa is one of the highest reported to date in the literature for undoped ZnO.

ESCRT-I fuels lysosomal degradation to restrict TFEB/TFE3 signaling via the Rag-mTORC1 pathway

ESCRT-I deficiency impairs lysosome membrane turnover and induces homeostatic responses to lysosomal nutrient starvation including activation of MiT-TFE signaling caused by inhibition of the substrate-specific mTORC1 pathway.

Within the endolysosomal pathway in mammalian cells, ESCRT complexes facilitate degradation of proteins residing in endosomal membranes. Here, we show that mammalian ESCRT-I restricts the size of lysosomes and promotes degradation of proteins from lysosomal membranes, including MCOLN1, a Ca²⁺ channel protein. The altered lysosome morphology upon ESCRT-I depletion coincided with elevated expression of genes annotated to biogenesis of lysosomes due to prolonged activation of TFEB/TFE3 transcription factors. Lack of ESCRT-I also induced transcription of cholesterol biosynthesis genes, in response to inefficient delivery of cholesterol from endolysosomal compartments. Among factors that could possibly activate TFEB/TFE3 signaling upon ESCRT-I deficiency, we excluded lysosomal cholesterol accumulation and Ca²⁺-mediated dephosphorylation of TFEB/TFE3. However, we discovered that this activation occurs due to the inhibition of Rag GTPase–dependent mTORC1 pathway that specifically reduced phosphorylation of TFEB at S122. Constitutive activation of the Rag GTPase complex in cells lacking ESCRT-I restored S122 phosphorylation and prevented TFEB/TFE3 activation. Our results indicate that ESCRT-I deficiency evokes a homeostatic response to counteract lysosomal nutrient starvation, that is, improper supply of nutrients derived from lysosomal degradation.

Selected properties of Al x Zn y O thin films prepared by reactive pulsed magnetron sputtering using a two-element Zn/Al target

Al _x Zn _y O thin films were obtained by reactive pulsed magnetron sputtering. A two-element Zn/Al planar target was used as source material prepared in the form of a Zn disc (100 mm diameter) with Al rings pressed into its surface. The sputtering processes were carried out in a mixture of argon and oxygen. The films were deposited with a discharge power of P _E = 400 W, which corresponded to a power density on the target surface of approximately 5 W/cm². The films were deposited on glass strip substrates, placed symmetrically over the target, making it possible to obtain films with different composition and thickness. The film sheet resistance was measured as a function of the distance from the target axis on both sides (front and back) of the substrate. The lowest measured resistivity was about 4 × 10^-3 Ω·cm. Additionally, optical properties, surface topography, and elemental composition were determined in selected areas of the substrate.

Investigation of a memory effect in a Au/(Ti-Cu)Ox-gradient thin film/TiAlV structure

This paper presents the results of the analysis of resistive switching properties observed in a Au/(Ti-Cu)Ox/TiAlV structure with a gradient distribution of Cu and Ti along the (Ti-Cu)Ox thin film thickness. Thin films were prepared via multisource reactive magnetron co-sputtering. The programmed profile of the pulse width modulation coefficient during sputtering of the Cu target allowed us to obtain the designed gradient U-shape profile of the Cu concentration in the deposited thin film. Electrical measurements of the Au/(Ti-Cu)Ox/TiAlV structure showed the presence of nonpinched hysteresis loops in the voltage-current plane testifying a resistive switching behavior. Results of optical, X-ray, and ultraviolet photoelectron spectroscopy measurements allowed us to elaborate the scheme of the bandgap alignment of the prepared thin films with respect to the Au and TiAlV electrical contacts. Detailed structure and elemental profile investigations allowed us to conclude about the possible mechanism for the observed resistive switching mechanism.

Long term outcomes of a coordinate care program in patients after myocardial infarction (KOS-MI)

Introduction

Despite significant progress in treatment of myocardial infarction (MI), the annual mortality remains a challenge. Since 2017, The Coordinated Care in Myocardial Infarction Program (KOS-MI) has been introduced in Poland, which guarantees and coordinates patients to achieve complete revascularization, electrotherapy when necessary, cardiac rehabilitation and access to cardiologist for patients after MI.

Purpose

The aim of this study was to assess long term outcomes (3-year follow-up) of patients enrolled in KOS-MI.

Methods

This is a prospective multicenter registry of 1973 consecutive patients with myocardial infarction hospitalized in 4 centers of American Heart of Poland from 11.2017 to 11.2018. Patients which constituted a study group were enrolled in KOS-MI program at discharge. A control group consisted patients who received standard of care. Propensity score matching was utilized for patients baseline characteristic matching and results adjustment. Follow-up was obtained from the National Health Fund registry citizens. Combine endpoint of MACCE consisted of death, MI, stroke and repeated revascularization.

Results

In total 753 patients were enrolled in KOS program and 1173 constituted a control group. More than 90% of patients in both groups underwent PCI. Patients in KOS-MI were mostly men (70% vs. 65%; p<0,05), were younger (65 vs. 68; p<0,05), admitted with STEMI (44,8% vs. 37,5%; p<0,05) with previous history of heart failure (23% vs. 17%; p<0,05). Patients in the control group had more comorbidities: chronic kidney disease (9,8% vs. 4,4%; p<0,05), previous AMI (17,6% vs. 12,6%; p<0,05), prior PCI (15,7% vs. 11%; p<0,05) and atrial fibrillation (11,7% vs. 8,4%; p<0,05). They were more often admitted with NSTEMI (62,5% vs. 55,3%; p<0,05) and acute heart failure (4,7% vs. 2,7%; p<0,05). KOS patients had more often completed revascularization performed (50% vs. 33,4%; p<0,05). Following propensity score matching 576 pairs were matched, and patient baseline characteristic were well balanced in all variables.

In long- term follow-up (mean 2,8±0,27 years) mortality was significantly lower in KOS group (9% vs. 16,3%; p<0,05) and MI similar (10,8% vs. 13,1%; p=0,14). MACCE was higher in the control group (43% vs. 30,2%; p<0,05). Prevalence of hospitalization for HF and repeated revascularization was higher in the control group (14,7% vs. 9,4%; p<0,05 and 27,9% vs. 21%; p<0,05, respectively). After adjustment MACCE remained significantly lower for KOS-MI, whereas there was tendency for lower mortality, hospitalization for HF and repeated revascularizations (Figure 1).

Conclusions

Combination and coordination of unrestricted rehabilitation, complete revascularization, electrotherapy and ambulatory cardiologist care in the KOS-MI program improves long term prognosis in patients after MI.

Funding Acknowledgement

Type of funding sources: None. Figure 1

Risk Management for a Legally Valid Informed Consent

ABSTRACT

Gelli-Bianco law (Law no. 24/2017) intervenes both in order to divide healthcare liability between the healthcare professional and the facility in which he/she exercises and to incentivize the latter to adopt an organizational model suitable for managing the risk associated with the provision of any healthcare service, including the information for consent. In fact, the healthcare facility must guarantee clear, complete and adequate information on the specific case, which, therefore, cannot consist of standard forms to be signed by the patient, under penalty of a flawed consent to treatment and consequent healthcare liability in the event of an adverse event. The regulation mandates that safety must be guaranteed through proper prevention tools and health care risk management, in con-junction with the most effective use of structural, technological and organizational resources available. It further spells out the obligation of health care professionals to contribute to risk prevention while administering health care procedures. For this reason, the consent information constitutes a source of risk for the responsibility of the healthcare provider and the Facility and it must necessarily be managed. Risk Management is the management tool that can allow the healthcare facility to improve the quality and safety of the services provided, optimizing the risk of adverse events through proper moni-toring of the same. This paper will be published, following a special agreement, on the two journals "Igiene e Sanità Pubblica" and "La Clinica Tera-peutica", in Italian and in English, in order to increase the diffusion to a wider audience.

Properties of Metallic and Oxide Thin Films Based on Ti and Co Prepared by Magnetron Sputtering from Sintered Targets with Different Co-Content

In this work, selected properties of metallic and oxide thin films based on titanium and cobalt were described. Thin-film coatings were prepared using the magnetron sputtering method. The deposition was carried out from sintered targets with different Co-content (2 at.%, 12 at.% and 50 at.%). The relation between the Ti–Co target composition and the Co-content in the metallic and oxide films was examined. There was 15–20% more cobalt in the films than in the target. Moreover, the deposition rate under neutral conditions (in Ar plasma) was even 10-times higher compared to oxidizing Ar:O₂ (70:30) plasma. A comprehensive analysis of the structural properties (performed with GIXRD and SEM) revealed the amorphous nature of (Ti,Co)Ox coatings, regardless of the cobalt content in the coating. The fine-grained, homogenous microstructure was observed, where cracks and voids were identified only for films with high Co-content. Optical studies have shown that these films were well transparent (60% ÷ 80%), and the amount of cobalt in the target from which they were sputtered had a significant impact on the decrease in the transparency level, the slight shift of the absorption edge position (from 279 nm to 289 nm) as well as the decrease in their optical band gap energy (from 3.13 eV to 1.71 eV). Electrical studies have shown that in (Ti,Co)Ox thin films, a unipolar memristive-like effect can be observed. The occurrence of such effects has not been reported so far in the case of TiO₂ coatings with the addition of Co.

A computed tomography comprehensive evaluation of the ostium of the sphenoid sinus and its clinical significance

BACKGROUND

The purpose of this research was to evaluate the size of the sphenoid sinuses' ostia, the distance between them and the distance between the medial margin of the ostia and the median line in the Polish adult population.

MATERIALS AND METHODS

The analysis was undertaken as a retrospective study of 296 computed tomography (CT) scans of patients (147 females, 149 males) with no comorbidities in their sphenoid sinuses. The paranasal sinuses were investigated by using Spiral CT Scanner (Siemens Somatom Sensation 16), in the option Siemens CARE Dose 4D, without administering any contrast medium. Having obtained transverse planes, multiplans reconstruction tool was used in order to glean sagittal and frontal planes.

RESULTS

The average size of both sphenoid sinuses ostia was 0.31 cm for both genders (for females ranging from 0.1 to 0.5 cm and from 0.1 to 0.6 cm for males). The mean distance between both sphenoid sinuses ostia was 0.6 cm for both genders (the range for females was 0.1-1.4 cm, whereas 0.1-1.8 cm for males). The average distance between the medial margin of the ostium and the median line was 0.32 cm for both genders (0.31 cm for females in the range of 0-0.9 cm and 0.32 cm for males in the range of 0-1 cm).

CONCLUSIONS

Intraoperative identification of the sphenoid sinus ostia might prove difficult and their inadequate excision could lead to potential iatrogenic complications, hence detailed anatomical descriptions are still warranted in specific populations in order to perform safe and effective procedures.

AB0601 COMPARISON OF THE EFFECT OF DIFFERENT PHYSICAL THERAPY PROGRAM IN THE REHABILITATION OF KNEE OSTEOARTHRITIS PATIENTS

Background:

Knee osteoarthritis (OA) is an increasingly common and disabling problem in worldwide. Exercises are considered the cornerstone of non-surgical management of knee OA and is recommended in all current clinical guidelines. The diversity of exercise programs determines the need to compare their efficiency, in order to recommend the best option for the patient.

Objectives:

The aim of the present study was to compare the effect on knee functionality of conventional exercises program and combinate with manual therapy in patients with knee osteoarthritis.

Methods:

164 patients that fulfilled the ACR classification criteria for knee osteoarthritis (127 females and 37 males) ranging in age from 42 to 84 years (mean 62,2 SD 8,76), participated in a 10 days two-arm randomized trial. One group (Gr.1) received an exercises program, the other group additionally manual therapy methods (Gr.2). Pain and function were measured with a Visual Analogue Scale (VAS, mm) and Knee Injury and Osteoarthritis Outcomes Score (KOOS) with 5 domains (Pain, Symptoms, Activity in Daily Living (ADL), Sport and recreation (Sport/rec.) and Quality of life (QoL)).

Results:

In the Gr.1 were 82 patients mean age 61,8±9,2 years and in Gr.2 – 82 patients 62,7±8,3 years (p>0.05). The initial level of pain (63,4±14,2 vs 60,2±18,8mm) and knee functionality according to KOOS (Tab1.) were similar in both groups, p>0.05. After 10 days rehabilitation program, VAS in Gr.1 was 39,6±14,8 mm, in Gr.2- 28,5±11,6 mm, (p<0.01). The KOOS results at the end of the rehabilitation program were with improvement, statistically significative in the Gr.2 (p<0,05).

Table 1.

The KOOS results at baseline and after 10 days of rehabilitation program.

KOOS scales(M±SD), %Group 1Group 2BaselineAfter 10 daysBaselineAfter 10 daysPain55,5 ±13,863,4±13,653,0±22,364,3±19,1Symptoms59,0±18,765,6±18,156,6±19,069,0±15,9ADL46,3±15,554,5±16,043,0±19,955,1±18,2Sport/rec15,6±17,323,1±19,616,0±24,330,5±23,6QoL29,3±22,236,5± 22,934,8±23,950,6±18,9

Conclusion:

The reduction of pain and recovery of function were found in both groups, with better results in patients who received manual therapy and exercises program. This study supports the routine manual therapy in rehabilitation program in patients with knee osteoarthritis.

Disclosure of Interests:

None declared.

Risk management and Healthcare responsibility. How to guarantee legal protection in Medicine

Having regard to the increasing attention to the issue of safety and health of patients and workers by low, the hypothesis that this topic will be the growing trend in the next years does not seem to be manifestly unfounded. For this reason, it is wise for healthcare professionals to already be aware that any violation of the interests underlying the legislation in question entails a ruling on civil and/or criminal liability. It is therefore necessary to identify the most suitable means to prevent undue harm occurring, partly to exempt healthcare professionals and hospitals from compensation costs, thereby providing them with recourse to insurance coverage. Healthcare facility organisations must adopt Risk Management techniques as a tool to simultaneously guarantee the effectiveness of health services (in this case), the efficiency of the management economy, and finally compliance with all legally required precautions. This will relegate the occurrence of an adverse event to remote and unpredictable hypotheses, thus guaranteeing useful recourse to insurance coverage to compensate any harm that does occur.

Anatomical variations of the superficial ulnar artery: case series observed on historical specimens prepared by Ludwik Karol Teichmann

BACKGROUND

In this report we present a series of cases representing variant origin and course of the ulnar artery, namely the superficial ulnar artery, observed during the review of collection of historical specimens prepared in the 19th century by the prominent Polish anatomist Ludwik Karol Teichmann and his collaborators, exhibited in the Anatomy Museum of Jagiellonian University Medical College.

RESULTS

Three distinct variants of the superficial ulnar artery were found on anatomical specimens of the upper limb with arteries injected by using Teichmann's method. In case No. 1, the superficial ulnar artery originated from the brachial artery slightly above the interepicondylar line of the humerus. This aberrant vessel gave off the common interosseous artery in the upper half of the cubital fossa and then ran superficially to the bicipital aponeurosis and over the muscles arising from the medial epicondyle of the humerus. The cases No. 2 and 3 involved two similar variants of the superficial artery in which the common interosseous artery arose from the radial artery. In the unique case No. 4, the superficial ulnar artery arose from the radial artery.

CONCLUSIONS

The superficial ulnar artery shows diverse anatomy regarding its topography and blood supply territory. Orthopedic, hand, and plastic surgeons should be aware of anatomic variations of the SUA both in planning and in conducting surgeries of the upper limb.

Challenges in diagnosing and managing non-cavitated occlusal caries lesions. A Literature overview and a report of a case

AIM

Aim of this literature overview was to analyze the diagnostic procedures of hidden caries lesions and to present a restorative protocol.

METHODS

A literature overview was performed in order to evaluate hidden caries etiological hypothesis and the reported prevalence. The diagnostic procedure is performed with the aid of an intra-oral fluorescence based camera and the restorative procedure is completed with the use of a novel bisphenol-A free composite.

RESULTS

Non cavitated occlusal caries lesions prevalence is high in young adults population. Diagnosis of hidden caries requires both high sensitivity and specificity.

CONCLUSIONS

The novel diagnostic and restorative protocol showed to be highly effective in hidden caries assessment and restoration.

Splicing variation of BMP2K balances abundance of COPII assemblies and autophagic degradation in erythroid cells

Intracellular transport undergoes remodeling upon cell differentiation, which involves cell type-specific regulators. Bone morphogenetic protein 2-inducible kinase (BMP2K) has been potentially implicated in endocytosis and cell differentiation but its molecular functions remained unknown. We discovered that its longer (L) and shorter (S) splicing variants regulate erythroid differentiation in a manner unexplainable by their involvement in AP-2 adaptor phosphorylation and endocytosis. However, both variants interact with SEC16A and could localize to the juxtanuclear secretory compartment. Variant-specific depletion approach showed that BMP2K isoforms constitute a BMP2K-L/S regulatory system that controls the distribution of SEC16A and SEC24B as well as SEC31A abundance at COPII assemblies. Finally, we found L to promote and S to restrict autophagic degradation and erythroid differentiation. Hence, we propose that BMP2K-L and BMP2K-S differentially regulate abundance and distribution of COPII assemblies as well as autophagy, possibly thereby fine-tuning erythroid differentiation.

The dimensions of the sphenoid sinuses: evaluation before the functional endoscopic sinus surgery

BACKGROUND

The following study aimed to evaluate the dimensions (anteroposterior, transverse and vertical) of the sphenoid sinuses in the adult population.

MATERIALS AND METHODS

The study was conducted as a retrospective analysis of the computed tomography (CT) scans of the paranasal sinuses of 296 patients (147 females and 149 males), who did not present any pathology in the sphenoid sinuses. The CT scans of the paranasal sinuses were done with the spiral CT scanner, without using any contrast medium. After obtaining transverse planes, frontal and sagittal planes were created using secondary reconstruction tool.

RESULTS

The anteroposterior dimension was found to be 2.65 cm on average, in the range of 0.5-4.3 cm. The transverse dimension was on average 1.98 cm, ranging from 0.5 cm to 4.9 cm. The average vertical dimension was found to be 2.1 cm, in the range of 0.7-3.7 cm.

CONCLUSIONS

Due to the high incidence of the anatomical variants of the paranasal sinuses, a CT scan is recommended in all patients before a planned surgery in order to avoid the potential iatrogenic complications. Dimensions of the sphenoid sinuses might point towards more at risk variants, but there is still a substantial amount of research that needs to be done in that aspect.

AB1316-HPR COMORBIDITIES IMPACT ON PHYSICAL REHABILITATION PROGRAM OUTCOMES IN PATIENTS WITH KNEE OSTEOARTHRITIS

Background:

Physical rehabilitation is proposed as a method of non-pharmacological treatment of knee osteoarthritis (OA) by the EULAR and OARSI recommendations. At the same time, presence of concomitant diseases could influence the condition of patients and the outcomes of the rehabilitation program.

Objectives:

To evaluate the frequency of comorbidities in OA patients and to appreciate their impact on outcomes of the physical rehabilitation program.

Methods:

A prospective control case study was conducted in the University Rehabilitation Center. The patients underwent clinical examination, VAS scale was used to assess level of pain, and Knee Injury and Osteoarthritis Outcome Score (KOOS) with 5 domains (Pain, Symptoms, ADL, Sport, QoL) for joint function assessment. These parameters were evaluated at the onset of the program (T0) and at the end of the 10th day (T1). Medical data records, general clinical exam and Charlson Comorbidities Index (CCI) assessed the comorbidities.

Results:

48 patients with OA were included in the study, 37 patients of them were found with comorbidities. The most frequent associated diseases were: cardiovascular- 76.6%, obesity-59.9%, and endocrine - 12.9% cases. At T0, significantly lower levels in the group with comorbidities were identified on the domains Pain, Sport and QoL. The CCI in patients with comorbidities was 3.29 ± 0.14 points (82.1% for 1-year survival rate). At the T1 moment, we found an improvement in joint functionality in both groups. The mean value of the VAS score group of patients without comorbidities decreased from 48,18 mm to 21,36 mm (p <0.05) and for the group of patients with comorbidities – 64,2 at / 36,2 mm (p<0.001). Significant improvement in joint function in the comorbidities group was in Pain (p <0.01), Sport (p <0.05) and Qol (p <0.01) domains, at the same in patients without comorbidities, the improvement was significant in all 5 domains.

Conclusion:

Comorbidities are highly associated to knee osteoarthritis and prove to have a negative influence on the results of the physical rehabilitation program; therefore, we would recommend to apply individualized rehabilitation programs adapted to the associated conditions of each patient.

Disclosure of Interests:

None declared

SAT0232 PERCEPTION OF THE DISEASE IN PATIENTS WITH EARLY SYSTEMIC LUPUS ERYTHEMATOSUS

Background:

Systemic lupus erythematosus is an autoimmune disease with a major impact on patient’s quality of life.

Objectives:

To evaluate patient’s attitude toward early disease and factors that influence it.

Methods:

Performed case-control study included SLE patients that fulfilled SLICC, 2012 classification criteria. The research included two groups of patients: early SLE – 1stgroup (disease duration ≤24 months) and non-early SLE – 2ndgroup control (disease duration >24 months). The pattern of the disease activity was assessed by patient global assessment (PGA), Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and Systemic Lupus Activity Measure (SLAM), for SLE activity, SLICC/ACR Damage Index (DI) for disease irreversible changes and SF-8 for the Quality of Life (QoL).

Results:

A total of 101 SLE patients with 34 in the 1stgroup (early SLE) and 67 in the 2ndgroup (non-early SLE) was analyzed. The disease activity showed high disease activity in both groups by SLEDAI (7,02±4,16 and 6,26±4,43 points, p>0,05) and SLAM (7,47±4,40 and 7,31±4,10 points, p>0,05) such as (46,97±19,39 vs 47,98±22,41 points). The QoL was appreciated as low, by both components (mental and physical), in groups. The damage index was higher in the 2nd group (0,23±0,43 and 1,07±1,29, p<0,001), which can be explained by the development of irreversible changes with the increase of disease duration.

The PGA in early SLE was influenced by subjective symptoms contained in SLAM index (r=0,48, p<0,05), such as fatigue and depression, and the level of the quality of life (r=0,65, p<0,001). Meantime, PGA in patients with longer disease duration (>2 years), was influenced by the presence of organ damage by SLICC/ACR DI (0,23, p<0,05) and objective findings of the disease activity contained in SLEDAI (r=0,33, p<0,005) and SLAM (0,44, p<0,001).

Conclusion:

The disease recognition in patients with early SLE was determined by subjective and psycho-emotional signs, while in patients with longer disease duration it was influenced by organ damage and complications.

References:

no references

Disclosure of Interests:

None declared

AB0360 EFFICACY AND SAFETY OF THE PROSTAGLANDIN EP4 RECEPTOR ANTAGONIST CR6086 ADDED TO METHOTREXATE IN DMARD-NAÏVE EARLY RA PATIENTS: A PHASE 2 RANDOMIZED CONTROLLED TRIAL

Background:

MTX is the first line treatment in early RA. There is robust evidence from cohort studies, but less from RCTs, that a “window of opportunity” exists over 12-16 weeks symptom duration. CR6086 is a selective prostaglandin EP4 receptor antagonist, with an immunomodulatory profile.

Objectives:

To test efficacy and safety of CR6086 added to MTX in early RA, DMARD-naïve patients.

Methods:

Patients with RA (ACR/EULAR 2010 criteria), < 1 year from symptom onset and naïve to DMARDs were randomized to oral CR6086 30, 90, 180mg, or placebo bid and oral MTX (20mg weekly) for 13 weeks (NCT03163966). Primary endpoint was the ACR20 response rate: 240 patients were needed to detect a difference among groups, with 50% responders on placebo and 70% on the 90mg CR6086 target dose. Pairwise comparisons of proportions were performed, with nonresponder imputation for withdrawals. A subgroup of patients underwent dynamic contrast-enhanced (DCE) MRI for quantification of synovitis at MCP and wrist joints, evaluated as DEMRIQ-ME and DEMRIQ-vol.

Results:

The ITT population included all 244 randomized patients receiving at least one dose of study drugs (59 CR6086 30mg/MTX, 60 CR6086 90mg/MTX, 63 CR6086 180mg/MTX, 62 placebo/MTX). Safety was good with no increased rate of infections or other disorders; however, there were more minor upper GI adverse events (AEs) with CR6086, and increased dropouts due to AEs with the 180mg dose (9/63, 14.3% vs 1.7-3.4% in other groups). There were more ACR20 responders with MTX monotherapy than predicted (59.7%) and thus the 10.3% difference with the 90mg target dose (70.0%) was not significant. The low 30mg dose was no better than placebo (55.9%), while the high 180mg dose did not provide additional benefit compared with 90mg (74.0% net of dropouts). CR6086 90mg and 180mg induced a significant improvement in MRI, compared with placebo (Fig. 1). In a post-hoc analysis in patients < 6 months from symptom onset (ACR definition of early RA: 98/244, 40.2%), MTX monotherapy exerted a large 76% ACR20 response rate that precluded potentiation. Conversely, in patients of 6-12 months disease duration (146/244, 59.8%) ACR20 responders were 48.6% with MTX monotherapy vs 68.4% with 90mg, i.e. a 19.8% difference as postulated, with proportional differences in secondary endpoints (Tab. 1).

Conclusion:

There was no benefit demonstrated for CR6086 added to MTX in the study cohort as a whole. However, in a post-hoc analysis, enhanced responses were observed with CR6086 90mg bid added to MTX in patients >6 months disease duration. This generated the hypothesis that addition of CR6086 90mg bid may benefit in RA patients initiating MTX after the window of opportunity, to be tested in further studies.

Table 1.

Patient characteristics & pregnancy outcomes

Symptom onset <12 months(principal analysis)Symptom onset 6-12 months(post-hoc analysis)*Placebo+MTX(N=62)CR6086 90mg+MTX(N=60)Placebo+MTX(N=37)CR6086 90mg+MTX(N=38)ACR20, %59.7%70.0%48.6%68.4%ACR50, %33.9%38.3%29.7%39.5%ACR70, %17.7%23.3%10.8%28.9%DAS28 (CRP) <2.6, %12.9%20.0%8.1%18.4%CDAI ≤2.8, %8.1%11.7%5.4%15.8%SDAI ≤3.3, %6.5%10.0%2.7%15.8%Boolean-based remission, %6.5%6.7%2.7%10.5%

*In patients with symptom onset <6 months, MTX monotherapy exerted a large 76% ACR20 response, and correspondingly high secondary efficacy parameters, precluding potentiation in this subset

Figure 1.

Change in MRI (DEMRIQ-ME#) after 13 weeks

Disclosure of Interests:

Karel Pavelka Consultant of: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Speakers bureau: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Ivanova Delina2 Delina: None declared, Minodora Mazur: None declared, Massimo D’Amato Employee of: Rottapharm Biotech, GIAMPAOLO GIACOVELLI Employee of: Rottapharm Biotech, Federica Girolami Employee of: Rottapharm Biotech, Marek Krogulec: None declared, René Østgård: None declared, Asger Reinstrup Bihlet Shareholder of: Nordic Bioscience A/S., Olga Kubassova Shareholder of: IAG, Image Analysis Group, Consultant of: Novartis, Takeda, Lilly, Employee of: IAG, Image Analysis Group, Lucio Rovati Shareholder of: Rottapharm Biotech, Employee of: Rottapharm Biotech, Peter C. Taylor Grant/research support from: Celgene, Eli Lilly and Company, Galapagos, and Gilead, Consultant of: AbbVie, Biogen, Eli Lilly and Company, Fresenius, Galapagos, Gilead, GlaxoSmithKline, Janssen, Nordic Pharma, Pfizer Roche, and UCB

Oral health in a cohort of individuals on a plant-based diet: a pilot study

INTRODUCTION

Plant-based diets are associated with a lower: (i) body mass index, (ii) rates of death from ischemic heart disease, (iii) serum cholesterol, (iv) incidence of high blood pressure, (v) type II diabetes mellitus and cancer, with an overall longer life expectancy. However, little data concerning the oral health in individuals on a plant-based diet are available.

AIM

The aim of the present study was to investigate the general and clinical oral health status in a cohort of adults who had been following a plant-based diet for a minimum of 24 months.

MATERIAL AND METHODS

For this purpose, individuals were administered two questionnaires (a.Questionnaire investigating risk areas for oral diseases; b. Italian version of the Oral Health Impact Profile -14 (IOHIP-14)) by a dental hygienist and clinical examination of the oral cavity was carried out.

RESULTS

Seventy-seven adult individuals were enrolled. On average, they followed a plant-based diet for the last four years, had four meals a day and brushed their teeth twice a day. Fruit was the most frequently consumed food at breakfast by 48 of the participants. Thirty-four responders did not drink beer or wine, 65 did not drink spirits, 57 avoided carbonated beverages and 62 (80.5%) did not consume any highly-sugared beverages. Different dental therapies in the previous three years were reported in 36 of the responders. Overall, answers "never and almost never" to the IOHIP-14 questionnaire were observed in 87% to 100% of the individuals. Multiple logistic regression analysis revealed that fresh fruit consumption at lunch had a protective effect against caries (p<0.05).

CONCLUSIONS

In conclusion, this study showed that individuals on a plant-based diet have good overall oral health conditions. These features are in agreement with the behavior of these subjects towards an overall healthy life style.

New theory of acoustic signal detection in the inner ear - An explanation of bifilar structure of the cochlea

In this work a new theory of acoustic signal detection in the inner ear and an experimental explanation of the causes of bifilar cochlear structure was presented. Our innovative approach describes sound detection in a completely different way from the one currently adopted. It requires analyzing the inner ear system in the form of a bent spiral and assuming that perilymph in such a small system behaves like a non-Newtonian fluid. The necessity of analyzing the system in the form of a bifilar spiral results from the need to compensate the head movements, so far omitted in the analysis. We suggest that the construction and the role of the oval window and the stapes are different than just a simple piston that converts mechanical signals to hydrokinetic ones. Stapes provides uniform distribution of the hydrokinetic signal in the spiral cochlear system, and the conversion of momentum to angular momentum creates a force perpendicular to the vestibular membrane, which causes the effect of its deflection, what has not yet been explained.

Four years of African swine fever in Poland. New insights into epidemiology and prognosis of future disease spread

Four and a half years of African Swine Fever (ASF) in population of free-ranging wild boars and domestic pigs revealed a number of novel insights into the disease epidemiology. Until No- vember 20th, 2018, in total 3048 cases in wild boars and 213 outbreaks in domestic pigs have been confirmed. In spite of low contagiosity as well as low rate of ASF spread in wild boars the disease has an enormous socio-economical impact on the production of pigs in Poland. One of the most important aspects which directly influences the dynamics of ASF spread is the unpredictable hu- man activity. Another important factor responsible for continuous ASF spread is fast recovery of wild boar population in spite of efforts taken by hunters. Assuming our scientific opinion ASF seems to be present in wildlife for the incoming few or several years. Therefore, extraordinary measures should be prepared and undertaken to limit the risk of the occurrence of future out- breaks in domestic pigs. One of the most crucial issues is implementation of strict biosecurity measures in all domestic pigs holdings.

Effects of controlled physical activity on immune cell phenotype in peripheral blood in prehypertension - studies in preclinical model and randomised crossover study

Hypertension (HT) is a global public health issue. There are many behavioural risk factors including unhealthy diet, tobacco use and alcohol consumption as well physical inactivity that contribute to the development of high blood pressure (BP) and its complications. Favourable effect of regular physical activity on treatment or prevention of hypertension by improvement of endothelial function is widely accepted however little is known about its relationship with immune system. Thus, the aim of this study was to assess the role of moderate regular physical activity on immune cell phenotype. T cell and monocyte subsets were characterised in 31 subjects with prehypertension (130 - 139 mmHg systolic and 85 - 89 mmHg diastolic blood pressure) who participated in moderate training (3 times/week) on cyclometers for 3 months in crossover study design. Complementary study was performed in murine model of Ang II-induced hypertension and ten-week-old animals were trained on a treadmill (5 times/week, 1 hour) for 2 weeks before and 1.5 weeks after minipumps implantation. In the context of elevated blood pressure regular physical activity had modest influence on immune cell phenotype. Both in human study and murine model we did not observe effects of applied exercise that can explain the mechanism of BP reduction after short-term regular training. Twelve-weeks regular training did not affect the activation status of T lymphocytes measured as expression of CD69, CD25 and CCR5 in human study. Physical activity resulted in higher expression of adhesion molecule CD11c on CD16+ monocytes (especially CD14 high) without any changes in leukocytes subpopulation counts. Similar results were observed in murine model of hypertension after the training. However the training caused significant decrease of CCR5 and CD25 expressions (measured as a mean fluorescence intensity) on CD8+ T cells infiltrating perivascular adipose tissue. Our studies show modest regulatory influence of moderate training on inflammatory markers in prehypertensive subjects and murine model of Ang II induced hypertension.

Controlled aerobic training improves endothelial function and modifies vascular remodeling in healthy adults with high normal blood pressure

The aim of the study was to assess endothelial function in adults with high normal blood pressure (HNBP) undergoing controlled aerobic training. The study was conducted among 31 volunteers with HNBP. Subjects underwent supervised cycle ergometer training for 12 weeks. Exercise intensity was assessed by monitoring the pulse with intention to keep the heart rate increase within the range of 40% to 65% of the heart rate reserve. The control group consisted of 14 healthy adults, not subjected to any intervention. The control group was examined twice at 12-week intervals (non-exercising time control). Vascular endothelial function was determined by flow-mediated dilation (FMD) and by measuring total nitric oxide products (NOx). The measurement of carotid intima-media complex thickness (IMT) was an indirect method of assessing vascular remodeling. Blood pressure (ABPM method), anthropological parameters and lipid profile were also assessed. There was a significant change in FMD after 3-month training in the study group: the average FMD training was 5.21 ± 2.17%, while after the program FMD increased to 9.46 ± 3.69% (P < 0.001). After training, the NO_x also increased from 1.01 ± 0.38 μmol/L to 1.27 ± 0.48 μmol/L (P < 0.001). Effects were observed irrespective of participants' sex. Interestingly, a modest but significant reduction of IMT was also observed, from 0.5 ± 0.06 mm to 0.46 ± 0.10 mm (P = 0.04). There was also a reduction in the percentage of body fat content from 25.01 ± 8.77% to 22.31 ± 8.79% (P < 0.001). No statistically significant changes were noted after 12 weeks of training in the blood pressure and lipid profile. In the control group no statistically significant changes of any parameter were observed. Regular aerobic exercise improves nitric oxide-dependent endothelial function of the vessels and can initiate regression of atherosclerosis in people with HNBP.

Association between P-selectin levels and left atrial blood stasis in patients with nonvalvular atrial fibrillation

BACKGROUND

P-selectin - a biomarker of platelet and endothelial cell activation is elevated in patients with non-valvular atrial fibrillation (NVAF). However, the association between sP-selectin level and thromboembolic complications in NVAF patients remains controversial. We tested the hypothesis that plasma soluble P-selectin (sPSL) level correlates with the measures of left atrial blood stasis in NVAF.

METHODS

Plasma sPSL concentration was measured using solid-phase ELISA in 103 NVAF patients (age 63 ± 14 years; 26% women) and 48 normal sinus rhythm controls (NSR; age 64 ± 14 years; 41% women) who were not on aspirin. Within the group of NVAF cases, 27 had no spontaneous echocardiographic contrast (SEC) detected by transesophageal echocardiography, 31had mild SEC, 15 moderate, 20 severe, and 10 patients had left atrial appendage thrombus (LAAT).

RESULTS

The median soluble sPSL level was higher in NVAF cases compared to NSR controls [(interquartile range) 26 (20-32) ng/mL vs 22 (15-29) ng/mL, p = 0.0045]. Only NVAF patients with CHA₂DS₂-VASc score ≥ 1 had higher sPSL level compared to NSR controls. Patients with severe SEC had significantly higher sPSL levels [32 (24-38) ng/mL] compared to all other NVAF patients (p = 0.0042) and to NSR controls (p < 0.0001). Also NVAF patients with LAAT had higher sPSL level compared to NSR controls.

CONCLUSIONS

There is a direct correlation between p-selectin level and severe blood stasis in the left atrium. Only NVAF patients with CHA₂DS₂-VASc score ≥ 1 or with LAAT had higher sPSL level compared to NSR controls.

Comparative analysis of human omental milky spots between the patients with colon cancer and the control group

AIM

Morphological description of milky spots (MSs) in the human greater omentum.

METHOD

Samples of the greater omentum collected during surgical procedures were subjected to further histological analysis. Two groups of patients were studied. Group A consisted of patients with colon cancer and peritonitis (stimulated MSs), group B consisted of patients without colon cancer and without peritonitis (unstimulated MSs). In the research, we focused on the cellular composition and differences between stimulated and unstimulated MSs.

RESULTS

MSs detected in the study were predominantly oval (67 %), round (12 %) or irregular in shape (21 %). The average number of immune cells found in one milky spot (MS) in the group A was 454 (209-694), consisted of T cells in 44.7 % (27-55 %), B cells in 26.8 % (16-34 %), macrophages in 18.3 % (12-27 %) and other immune cells in 10.2 % (6-18 %). The average number of immune cells found in one MS in the group B was 58 (42-100 %), consisted of T cells in 21.1 % (16-22 %), B cells in 18.7 % (13-22 %), macrophages in 46.9 % (33-60 %) and other immune cells in 13.3 % (1-22 %). The average size of MSs in the group A was significantly higher than in the group B: 768 μm (313-1075) to 293 μm (197-421). The results showed that there were significant differences in terms of strong predominance of macrophages in unstimulated milky spots and strong predominance of T cells in stimulated milky spots.

CONCLUSION

MSs are specific immune active lymphatic structures on the greater omentum. They play a key role in defense mechanism, especially in peritonitis. Their function is not completely clear in cancer, some authors suggest they might play a significant role in omental metastasis. Further analysing of the morphology and cells interactions of MSs is needed (Tab. 2, Fig. 6, Ref. 20).

Clinical comparison between an opaque and a clear pit and fissures sealants: a 12-month split-mouth, randomized controlled study

TRIAL DESIGN

We design a clinical splith-mouth, randomized controlled study, in which the retention of an opaque and clear pit and fissures sealants were evaluated and their effectiveness compared at 6 and 12 months of follow up. A secondary aim was to evaluate the possibility of using a fluorescence based intra-oral camera through the clear sealant to monitor enamel demineralization.

METHODS

Consecutive young adolescents with at least two molars with code 0, 1, 2 caries evidenced following the International Caries Detection and Assessment System (ICDAS II) were enrolled. A split-mouth randomized allocation was carried out. One skilled operator applied the sealant under 3.5 X magnification. A second operator evaluated clinical retention and performed the intra-oral camera assessments at 6 and 12 months follow up.

RESULTS

A total of 42 patients, (20 males and 22 females, mean age 14.25) with 176 dental lesions were enrolled. Nine patients dropped out accounting for 26 teeth lost during follow up. Overall, a total of 150 sealed teeth were evaluated in the study. In 77 cases the clear sealant was used, while in 73 the opaque sealant was utilized. The opaque sealant rated 100% complete retention at 6 months, and 97.3% at 12 months, while the clear selant 91.8% and 85.9% respectively. Demineralization under clear selant was registered when sealant partial detachment occurred.

CONCLUSIONS

The overall retention rate of an opaque sealant was higher than that of a clear sealant after 12 months of follow-up. This difference may partly be due to difficulty in clinical detection of clear sealants during follow-up. Fluorescence based intra-oral camera seems useful to monitor enamel demineralization in clear sealant.

[Knowledge, attitude and behavior towards oral health: gender differences between parents]

OBJECTIVES

The aim of this study is to compare the results of a survey carried out on a sample of mothers and fathers about the knowledge and personal attitudes towards their own oral health and in terms of attention to that of their children. Mutual analogy and cognitive and behavioral differences between parents have been evaluated; in particular as the early assumption of a healthy lifestyle can influence the proper development of their children.

MATERIALS AND METHODS

This survey was conducted using a paper questionnaire distributed to a population of parents, men and women, in several private dental practices in Rome. The study lasted about three months.

RESULTS

The results obtained from this study show that values obtained by mothers and fathers are essentially equivalent, there are no statistically significant differences (p> 0.05).

CONCLUSIONS

This study has shown that there are no significant thinking and behavioral differences between parents regarding their oral hygiene and that of their children. Both parents have been shown to recognize the importance of continuous monitoring and to be aware of techniques and oral hygiene aids suitable for adults and children, although this knowledge is not always applied in daily lifestyles and oral hygiene.

Oral health sentinel-based surveillance: a pilot study on dentinal hypersensitivity pain

Aim of the study is to assess the development of a structured sentinel system for oral health data collection at national level. Furthermore, this pilot study aims to investigate the prevalence data on dentinal sensitivity pain collected through a nationwide network of epidemiological sentinels (dental hygienists). Each sentinel was given a specific number of examinees and periodicity of data collection. Overall, 116 adults were recruited from 19 Regions, 42,24% male and 57,76% female, with a mean age of 26. DH result was consistent with literature data, being 45%. All sentinel completed the standard forms and assured a good compliance. The overall good customer satisfaction assures adhesion of the sentinels to the procedure, and the regular data collection. The pilot study proved the effectiveness of a structured nationwide network of epidemiological sentinels (dental hygienists) for oral health data collection at national level. This methodology can be an essential starting point for periodic comparative studies.

[Omentum majus and milky spots as an important part of the immune system]

INTRODUCTION

Description and analysis of human omental milky spots is still not sufficiently clarified. In our study we describe the morphology of human omental milky spots and we also bring together a summary of the current knowledge of their function based on the available literature.

METHOD

Samples of the omentum majus were collected preoperatively during surgical procedures in Vítkovice Hospital and subsequently subjected to further processing and histological analysis. Histological sections were stained with hematoxylin and eosin with a focus on the milky spots morphology and comparison of two groups of patients.

RESULTS

Milky spots detected in the study were predominantly oval 56% (n=10), irregular in shape 28% (n=5) and round 16% (n=3). The average number of immune cells found in one milky spot in group A was 435 (194620). The average number of immune cells found in one milky spot in group B was 54 (40112). All milky spots were unencapsulated, macroscopically, they appear as furtive structures resembling white cotton balls. 72% (n=13) of milky spots were covered by mesothelial cells.

CONCLUSION

Milky spots are small submesothelial lymphatic structures found in the omentum majus. They are in contact with the peritoneal cavity. They have their own vascular supply and no capsule. Our results show that the number and size of omental milky spots increase in patients with peritonitis.Key words: omentum majus milky spots - morphology surgery.

[Polymastia in unusual localization during pregnancy]

Polymastia is a fairly well-described and not entirely uncommon developmental anomaly in embryogenesis of the breast. It occurs in the milk line, most often in the axila but may also be present outside of this area. Clinical manifestation of polymastia is due to sex hormones, especially during puberty, pregnancy and lactation. Supernumerary/ aberrant breasts can undergo the same pathological changes, such as benign and malignant, as normally positioned breasts. In our case report we present a case of a pregnant patient with axillary polymasty bilaterally with benign tumors by ultrasound, further in anal and labia majora area.Key words: polymastia aberrant breast - gravidity gigantomastia.

Filgotinib (GLPG0634/GS-6034), an oral JAK1 selective inhibitor, is effective in combination with methotrexate (MTX) in patients with active rheumatoid arthritis and insufficient response to MTX: results from a randomised, dose-finding study (DARWIN 1)

OBJECTIVES

To evaluate the efficacy and safety of different doses and regimens of filgotinib, an oral Janus kinase 1 inhibitor, as add-on treatment to methotrexate (MTX) in patients with active rheumatoid arthritis (RA) and inadequate response to MTX.

METHODS

In this 24-week phase IIb study, patients with moderate-to-severe active RA receiving a stable dose of MTX were randomised (1:1:1:1:1:1:1) to receive placebo or 50, 100 or 200 mg filgotinib, administered once daily or twice daily. Primary end point was the percentage of patients achieving a week 12 American College of Rheumatology (ACR)20 response.

RESULTS

Overall, 594 patients were randomised and treated. At week 12, significantly more patients receiving filgotinib 100 mg once daily or 200 mg daily (both regimens) achieved an ACR20 response versus placebo. For other key end points at week 12 (ACR50, ACR-N, Disease Activity Score based on 28 joints and C reactive protein value, Clinical Disease Activity Index, Simplified Disease Activity Index and Health Assessment Questionnaire-Disability Index), differences in favour of 100  or 200 mg filgotinib daily were seen versus placebo; responses were maintained or improved through to week 24. Rapid onset of action and dose-dependent responses were observed for most efficacy end points and were associated with an increased haemoglobin concentration. No significant differences between once-daily and twice-daily regimens were seen. Treatment-emergent adverse event rates were similar in placebo and filgotinib groups. Serious infections occurred in one and five patients in the placebo and filgotinib groups, respectively. No tuberculosis or opportunistic infections were reported.

CONCLUSIONS

Filgotinib as add-on to MTX improved the signs and symptoms of active RA over 24 weeks and was associated with a rapid onset of action. Filgotinib was generally well tolerated.

TRIAL REGISTRATION NUMBER

NCT01888874.

Influence of Cu, Au and Ag on structural and surface properties of bioactive coatings based on titanium

In this work influence of copper, silver and gold additives on structural and surface properties of biologically active thin films based on titanium have been described. Coatings were prepared by magnetron sputtering method. During each process metallic discs (targets) - Ti and the additive (Cu, Ag or Au) were co-sputtered in argon atmosphere. Structural investigation of as-deposited coatings was performed with the aid of XRD and SEM/EDS method. It was found that all prepared thin films were homogenous. Addition of Cu, Ag and Au resulted in nanocrystalline structure. Moreover, influence of these additives on hardness and antibacterial activity of titanium coatings was also studied. Ti-Cu, Ti-Ag and Ti-Au films had lower hardness as-compared to Ti. According to AAS results the difference of their activity was related to the ion migration process. It was found that Ti-Ag and Ti-Au coatings had biocidal effect related to direct contact of their surface with microorganisms. In the case of Ti-Cu antimicrobial activity had direct and indirect nature due to efficient ion migration process from the film surface to the surrounding environment. Functional features of coatings such as wettability and corrosion resistance were also examined and included in the comprehensive analysis.

[Lumbar sympathectomy literature review over the past 15 years]

INTRODUCTION

Lumbar sympathectomy (LS) irreversibly damages a part of the sympathetic trunk and adjacent ganglia between L1 and L5, typically between L2 and L4. The first LS was performed in 1923. Initially, it used to be performed very often; however, with the progress of vascular and endovascular surgery its importance gradually continues to decline. The aim of the paper is to present literature review focusing on LS over the past 15 years.

METHOD

Literature review of 113 academic articles found in academic journal databases.

PATHOPHYSIOLOGY

Irreversible interruption of the efferent innervation leads to relative vasodilation of small vessels in lower extremities (α1-receptors blockade), and it reduces the volume of sweat due to inactivation of eccrine glands and nociception from lower limbs.

INDICATION

Raynaud´s phenomenon, thromboangitis obliterans, non-revascularizable peripheral arterial disease (PAD) (Fontain grade III-IV), hyperhidrosis, persistent pain in lower extremities, chronic pain of amputation stump, frostbites, chilblains.Effect: The three largest studies showed a positive effect in 63.6-93.4% cases of PAD and in 97%100% cases of hyperhidrosis. The positive effect was defined as warmer lower extremities, increased blood flow, acceleration of chronic defects healing, sweating disappearance and pain reduction.

CONCLUSION

Lumbar sympathectomy still remains a useful method in the treatment of above mentioned diseases if properly indicated.

KEY WORDS

lumbar sympathectomy - Raynaud´s phenomenon - thromboangitis obliterans -peripheral arterial disease - hyperhidrosis.