Botulinum-A toxin injections into the detrusor muscle decrease nerve growth factor bladder tissue levels in patients with neurogenic detrusor overactivity

Purpose: We investigated the effects of BTX-A on visceral afferent nerve transmission by measuring bladder tissue NGF levels in patients with neurogenic detrusor overactivity before and after intravesical treatment with BTX-A. We also compared the bladder tissue NGF content with clinical and urodynamic data. Materials and Methods: A total of 23 patients underwent clinical evaluation and urodynamics with detection of the UDC threshold, maximum pressure and maximum cystometric capacity before, and at the 1 and 3-month followups. Endoscopic bladder Wall biopsies were also obtained at the same time points. NGF levels were measured in tissue homogenate by enzyme-linked immunosorbent assay (Promega, Madison, Wisconsin). Results: At 1 and 3 months mean catheterization and incontinent episodes were significantly decreased (p < 0.05 and < 0.001, respectively). On urodynamics we detected a significant increase in the UDC threshold and maximum cystometric capacity, and a significant decrease in UDC maximum pressure at the 1 and 3-month followups compared to baseline (each p < 0.001). At the same time points we detected a significant decrease in NGF bladder tissue content (each p < 0.02). Conclusions: BTX-A intravesical treatment induces a state of NGF deprivation in bladder tissue that persists at least up to 4 months. As caused by BTX-A, the decrease in acetylcholine release at the presynaptic level may induce a decrease in detrusor contractility and in NGF production by the detrusor muscle. Alternatively BTX-A can decrease the bladder level of neurotransmitters that normally modulate NGF production and release

The Mask Fitter, a Simple Method to Improve Medical Face Mask Adaptation Using a Customized 3D-Printed Frame during COVID-19: A Survey on Users’ Acceptability in Clinical Dentistry

Featured Application: The paper shows the procedure for producing a customized low-cost “Mask Fitter” made with a tablet-based 3D-face-scan and 3D-printing that could improve the sealing of FFP2 respirators. COVID-19 has deeply impacted clinical strategies in dentistry and the use of surgical masks and respirators has become critical. They should adapt to the person’s facial anatomy, but this is not always easy to achieve. Bellus3D Company proposed to apply their face scan software, used with selected smartphones and tablets, to design and 3D-print a bespoke “Mask Fitter” to improve the sealing of surgical masks and respirators. Twenty dental staff participants were face scanned and a Mask Fitter for FFP2 respirators was designed and 3D-printed. Participants were asked to wear their Mask Fitter over one week and then completed a survey. Questions were asked about wearing comfort, sealing confidence, glasses or loupes fogging, both with and without the Mask Fitter. Dental staff gave positive feedback, with levels of comfort during daily use reported as similar with and without the Mask Fitter; and a higher confidence in achieving a proper seal, ranging from a 10% confidence rating of a proper seal without the Mask Fitter to 75% with the Mask Fitter. Moreover, fogging problems decreased considerably. The tested Mask Fitter device could represent an easy and low-cost procedure to improve the facial adaptation of the FFP2 respirator

Social cognition in people with schizophrenia: A cluster-analytic approach

Background The study aimed to subtype patients with schizophrenia on the basis of social cognition (SC), and to identify cut-offs that best discriminate among subtypes in 809 out-patients recruited in the context of the Italian Network for Research on Psychoses. Method A two-step cluster analysis of The Awareness of Social Inference Test (TASIT), the Facial Emotion Identification Test and Mayer-Salovey-Caruso Emotional Intelligence Test scores was performed. Classification and regression tree analysis was used to identify the cut-offs of variables that best discriminated among clusters. Results We identified three clusters, characterized by unimpaired (42%), impaired (50.4%) and very impaired (7.5%) SC. Three theory-of-mind domains were more important for the cluster definition as compared with emotion perception and emotional intelligence. Patients more able to understand simple sarcasm (14 for TASIT-SS) were very likely to belong to the unimpaired SC cluster. Compared with patients in the impaired SC cluster, those in the very impaired SC cluster performed significantly worse in lie scenes (TASIT-LI &lt;10), but not in simple sarcasm. Moreover, functioning, neurocognition, disorganization and SC had a linear relationship across the three clusters, while positive symptoms were significantly lower in patients with unimpaired SC as compared with patients with impaired and very impaired SC. On the other hand, negative symptoms were highest in patients with impaired levels of SC. Conclusions If replicated, the identification of such subtypes in clinical practice may help in tailoring rehabilitation efforts to the person's strengths to gain more benefit to the person

Influence of low-ph beverages on the two-body wear of cad/cam monolithic materials

The aim of this in vitro study is to evaluate the effect of different acidic media on volumetric wear and surface roughness of CAD/CAM monolithic materials. Forty-eight rectangular specimens were prepared using different CAD/CAM monolithic materials: nanohybrid composite (Grandio Blocks, Voco), resin-based composite (Cerasmart, GC), lithium disilicate (E-Max, Ivoclar), and high-translucency zirconia (Katana STML, Kuraray Noritake). After storage in distilled water at 37◦ C for two days, the specimens were tested using a chewing machine with a stainless-steel ball as an antagonist (49N loads, 250,000 cycles). Testing was performed using distilled water, Coca-Cola, and Red Bull as abrasive media. Wear and surface roughness analyses of the CAD/CAM materials were performed using a 3D profilometer and analyzed with two-way analysis of variance and post hoc pairwise comparison procedures. Worn surfaces were examined using scanning electron microscopy. Resin-based materials suffered higher volumetric wear than ceramics (p = 0.00001). Water induced significantly less volumetric wear than the other tested solutions (p = 0.0014), independent of the material tested. High-translucency zirconia showed less surface roughness than all the other materials tested. The selection of monolithic CAD/CAM materials to restore worn dentition due to erosive processes could impact restorative therapy stability over time. Resin-based materials seem to be more influenced by the acidic environment when subjected to a two-body wear test

Influence of Modeling Liquids and Universal Adhesives Used as Lubricants on Color Stability and Translucency of Resin-Based Composites

The use of lubricants during restorative procedures is a clinically common practice to alleviate the stickiness of resin-based composite (RBCs) materials and to improve its handling. This study evaluated the effects of three modeling liquids (ML) and one universal adhesive (UA) used as lubricants during composite layering on the color stability and translucency of RBCs. Methods. The following materials were applied between every 1 mm RBC layer (total restoration height of 4 mm): GC modeling liquid (GCML, GC Corporation, Tokyo, Japan), composite wetting resin (UPWR, Ultradent Products, South Jordan, UT, USA), Bisco modeling resin (BSMR, Bisco Inc., Schaumburg, IL, USA) as an ML and Clearfil Universal Bond Quick (KUBQ, Kuraray Noritake Dental, Tokyo, Japan) as a UA. Lubricant-free specimens were used as the control. Color coordinates (L*, a* and b*) were recorded at baseline and after a simulation of 1 month of coffee consumption. Data were analyzed using ANOVA and a post hoc Tukey test (p &lt; 0.05). Results. All lubricants induced a color change higher than the perceptibility threshold (ΔE00 &gt; 0.81). GCML showed the highest color stability. The use of KUBQ resulted in significantly higher a* values (p = 0.001) at baseline and after staining. KUBQ and UPWR significantly influenced the color stability (ΔE00, p = 0.0001) after staining, overcoming the clinical acceptability threshold (ΔE00 &gt; 1.77). Conclusions. The use of lubricants may affect color stability at baseline and after simulation of staining. Translucency was not affected at baseline nor after staining. Clinical Significance. Clinicians should be aware that some lubricants may affect color stability, even at baseline

The relationship between peritraumatic distress, mental health symptoms, and functioning impairment in healthcare workers during the COVID-19 emergency

Objective. Healthcare workers (HCWs) were considered a population at risk for developing psychiatric symptoms during the COVID-19 pandemic, such as anxiety, depression, and post-traumatic stress disorder (PTSD). Peritraumatic distress is associated with post-traumatic psychopathological symptoms; however, little is known about how it may affect functioning. The study aimed at evaluating the level of peritraumatic distress in a sample of HCWs during the first wave of the COVID-19 pandemic and at examining the relationship between peritraumatic distress, mental health symptoms, and functioning impairment. Methods. A sample of 554 frontline HCWs were consecutively enrolled in major university hospitals and community services in Italy. The PDI, IES-R, PHQ-9, and GAD-7 were used to assess peritraumatic distress, symptoms of PTSD, depression, and anxiety, respectively, and the WSAS to investigate functioning impairment. PDI scores were higher among females, community services, physicians, and nurses. Furthermore, the PDI correlated significantly with the GAD-7, PHQ-9, IES-R, and WSAS. Results. In a mediation analysis, the direct effect of PDI on WSAS and the indirect effects through the PHQ-9 and IES-R were statistically significant (P &lt; .001). Conclusion. Peritraumatic distress reported by HCWs was associated with symptoms of PTSD, depression, and anxiety, but the association with reduced functioning may be only partially mediated through symptoms of depression and PTSD