Lacosamide monotherapy in clinical practice: A retrospective chart review

Objective: To assess effectiveness and tolerability of first-line and conversion to lacosamide monotherapy for focal seizures. Materials and Methods: Retrospective, non-interventional chart review of lacosamide monotherapy patients aged ≥16 years in Europe. Outcomes included retention rate at observational point (OP) 3 (12 ± 3 months), seizure freedom rates at OP2 (6 ± 3 months) and OP3 and adverse drug reactions (ADRs). Results: A total of 439 patients were included (98 first-line and 341 conversion to monotherapy; 128 aged ≥65 years [25 first-line and 103 conversion to monotherapy]). First-line and conversion to monotherapy retention rates were 60.2% (59/98; 95% confidence interval [CI] 49.8%-70.0%) and 62.5% (213/341; 57.1%-67.6%), respectively. Kaplan-Meier estimates of 12-month retention rates were 81.2% and 91.4% for first-line and conversion to monotherapy, respectively. First-line and conversion to monotherapy retention rates in patients aged ≥65 years were 60.0% (38.7%-78.9%) and 68.9% (59.1%-77.7%), respectively. At OP2, 66.3% of first-line and 63.0% of conversion to monotherapy patients were seizure free. At OP3, 60.2% of first-line and 52.5% of conversion to monotherapy patients were seizure free. In the ≥65 years subgroup, seizure freedom rates at OP2 were 72.0% and 68.0% for first-line and converted to monotherapy, respectively, and at OP3, 68.0% and 56.3%, respectively. Overall, 52 of 439 (11.8%) patients reported ADRs (16.4% in ≥65 years subgroup), most commonly dizziness (5.0%), headache (2.1%) and somnolence (1.6%). Conclusions: Lacosamide was effective and well tolerated as first-line or conversion to monotherapy in a clinical setting in adult and elderly patients with focal seizuresThis study was supported by UCB Pharm

Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage

Background: The irradiation of head and neck cancer (HNC) often causes damage to the salivary glands. The resulting salivary gland hypofunction and xerostomia seriously reduce the patient\u2019s quality of life. Purpose: To analyze the literature of actual management strategies for radiation-induced hypofunction and xerostomia in HNC patients. Methods: MEDLINE/PubMed and the Cochrane Library databases were electronically evaluated for articles published from January 1, 1970, to June 30, 2013. Two reviewers independently screened and included papers according to the predefined selection criteria. Results: Sixty-one articles met the inclusion criteria. The systematic review of the literature suggests that the most suitable methods for managing the clinical and pathophysiological consequences of HNC radiotherapy might be the pharmacological approach, for example, through the use of cholinergic agonists when residual secretory capacity is still present, and the use of salivary substitutes. In addition, a modified diet and the patient\u2019s motivation to enhance oral hygiene can lead to a significant improvement. Conclusion: Radiation-induced xerostomia could be considered a multifactorial disease. It could depend on the type of cancer treatment and the cumulative radiation dose to the gland tissue. A preventive approach and the correct treatment of the particular radiotherapeutic patient can help to improve the condition of xerostomia

An Experimental Method to Add New Prosthetic Teeth in the Removable Partial Denture Framework: TIG Cold Welding and Preformed Pins

The need to modify removable partial dentures equipped with a metal framework in order to add other prosthetic teeth to replace natural teeth lost by the patient could lead to laboratory procedures so complex as to require the creation of new prostheses with a heavy economic burden. The creation of preformed metal pins to be welded using the economical TIG cold welding method could represent a valid alternative solution with the aim of modifying the prostheses using a rein-forced resin capable of adequately resisting masticatory loads. This study evaluates and compares the mechanical robustness and the clinical reliability of these modified prostheses in cases of junctions of one or two contiguous prosthetic teeth. The 6-month follow-up demonstrated the total validity of the method via the absence of significant breakages or detachments in all of the patients analyzed; on the other hand, the prostheses modified using the traditional method and used as controls showed a high incidence of fractures

“1st Amendment Rights, BABY!”: Banned Books Week on a College Campus

Since 2021, the American Library Association has reported a marked increase in the number of book challenges in the United States. Public and school libraries, where most of these attempts at censorship occur, frequently celebrate Banned Books Week each fall, to raise awareness about the ongoing threat to intellectual freedom. College and university libraries face fewer book challenges and might not celebrate Banned Books Week; however, given the rise in number and visibility of conversations surrounding book banning, hosting events on the week’s theme offers academic libraries a way to engage their students thoughtfully in civic conversations. This practical article details the planning, promotion, and assessment process one university library in Alabama undertook as it responded to recent local issues by implementing programming during Banned Books Week

The Freehand Technique: The Ability of the Human Eye to Identify Implant Sites on the Patient

In implantology, among the key choices, to obtain predictable results, it is essential to establish, using cone beam computed tomography (CBCT), the bone site and where to insert the implants; during the surgical phase, these sites must be identified on the oral mucosa. Surgical templates are a valid aid, especially in complex cases which require the insertion of more than three or four implants. In cases of a single implant, on the other hand, surgical guides are rarely used, and the implant is often inserted freehand; therefore, the identification of the implant site on the oral mucosa (after choosing the location on the CBCT) is more difficult. For this reason, the clinician uses the teeth in the arch as a reference. This study evaluates the ability of the human eye to identify, on the oral mucosa, where the implant collars will be positioned, the position of which has previously been chosen on the CBCT, in cases where the hands-free surgical technique (without surgical guides) is used. The verification of this precision is carried out using particular thermo-printed templates which contain radiopaque metal spheres. The results show that, in the freehand technique, it is difficult to precisely identify the implant sites (chosen via X-ray) on the mucosa, especially when they are far from natural teeth adjacent to the edentulous area. In case of monoedentulism, the freehand implant technique seems to be applicable by expert implantologists with a reduced risk of error; in fact, clinical experience helps to find the correct correspondence between the implant site chosen on the CBCT and its identification on the mucosa. The level of experience is fundamental in the clinician’s decision about whether or not to use surgical guides; in fact, doctors with little experience should use surgical guides even in the simplest cases to reduce the risk of error

Soldering in Dentistry: An Updated Technical Review

Introduction: The need to permanently join two or more pieces of metal using heat is a frequent condition in various fields of medicine such as dentistry. Welding, brazing and soldering are permanent joining techniques between different metals that require in-depth background knowledge in order to obtain predictable results. Aim: This review examines the different methods of joining metals using heat and their fields of application. Discussion: It is possible to create permanent metal joints in various phases of the creation of final products that will be used on the patient. In several cases, welds are also made directly by the manufacturer during industrial processing. In dentistry, dental laboratories perform complex welds mainly on dental prostheses and orthodontic appliances during the production process. It is also possible to obtain intraoral welding carried out by the clinician inside the patient’s oral cavity. Welding can be carried out using combustible gases, electric current, infrared light and laser light through different technical procedures which must be chosen according to the specific needs and the metals to be joined. Conclusions: It is useful for the dentist and dental technician to know the different welding methods, including those carried out in the factory by the manufacturer, to better understand the physical properties and mechanical resistance of the components marketed for the construction of prostheses and orthodontic appliances. The enormous variety of conditions in which those who practice welding can find themselves therefore presupposes in-depth knowledge in this field in order to apply the most suitable technique

Evaluation and Comparison of Capillary Morphology Among Combusted Tobacco, Heated Tobacco and E-Cigarette Users

The habit of smoking in its various forms represents a significant public health concern due to its wide range of pathological effects, included the oral cavity. In recent years, alternatives to traditional cigarettes, such as heated tobacco products and electronic cigarettes, have gained popularity and are often marketed as potentially less harmful options. This study seeks to evaluate and compare the morphometric characteristics of oral mucosal capillaries in individuals who consume combusted tobacco, heated tobacco, vaporized liquid, and non-smokers. Using videocapillaroscopy, we assessed both parametric and non-parametric data from 60 patients, divided into four groups according to their smoking habits. The analysis revealed significant differences in capillary morphology among the groups. Users of combusted tobacco exhibited pronounced reductions in capillary diameter, alongside increased tortuosity and the presence of microaneurysms. These alterations are indicative of chronic inflammation and vasoconstriction, likely driven by exposure to nicotine and the high temperatures associated with combustion. Conversely, users of heated tobacco and vaporized liquid exhibited comparatively fewer vascular abnormalities, although angiogenic effects attributable to nicotine were still observable. These findings suggest that alternative tobacco products may have a comparatively lesser impact on the oral microcirculation when compared to traditional smoking. However, the potential long-term effects of these products remain unclear. Further longitudinal research is required to fully understand the risks associated with prolonged use of heated tobacco and electronic cigarettes