Search Results (434)

Background/Objectives: Osseointegration is essential for the long-term success of dental implants, and radiographic assessment may support the evaluation of peri-implant bone healing. This retrospective study evaluated peri-implant radiographic bone density (PIBD) as a potential indicator of osseointegration in patients who underwent successful implant-prosthetic rehabilitation. Methods: Patients with at least one endosseous dental implant and a minimum of two standardized periapical radiographs—one at placement (T0) and one during follow-up—were included. Digital radiographs were obtained using the paralleling technique and analyzed with ImageJ^®. Normalized bone density values were calculated for predefined areas of interest (AOIs). Marginal Bone Level (MBL) changes were also assessed. Statistical analyses included the Shapiro–Wilk test, Kruskal–Wallis test, and Dunn’s post hoc test with Bonferroni correction. Results: 88 implants in 64 patients were analyzed (198 radiographs; 1299 AOIs measurements). Normalized bone density showed significant temporal changes in several AOIs, mainly from 3 to 12 months, across coronal/middle/apical regions. PIBD decreased by approximately 8% between T0 and 3 months, followed by a significant increase at one year. MBL values were minimal and well below physiologic thresholds throughout follow-up. No significant correlation was found between MBL and normalized bone density. Conclusions: PIBD assessment may be a reliable, non-invasive tool for monitoring osseointegration during follow-up and supporting clinical decision-making in postoperative controls. The temporal pattern observed confirms three radiographic healing phases after implant placement: an initial decrease in PIBD during early remodeling, a subsequent increase reflecting osseointegration, and a final stabilization phase corresponding to tertiary implant stability. Full article

Background/Objective: Long COVID is an important cause of disability following SARS-CoV-2 infection; yet, its underlying mechanisms are not completely understood. One proposed mechanism is the long-lasting dysregulation of the immune complement system. This systematic review is the first to summarize the current evidence and evaluate the potential role of long-lasting complement activation in people with long COVID. Methods: A systematic electronic search on PubMed, MEDLINE, CINAHL, and Embase was conducted up to 15 October 2025, to identify studies investigating complement activation in people with the post-COVID-19 condition. The Newcastle–Ottawa Scale was used to evaluate the risk of bias and methodological quality. Results: Among the 247 studies initially identified, eleven met the inclusion criteria, comprising 1435 individuals (age: 48.5 years, 70% females) with long COVID and 1124 controls (age: 43.6 years, 60% females). All studies were of a high quality, with scores ranging from 7 to 8 stars (mean: 7.6 ± 0.5). The activation of the classical complement pathway was investigated in nine studies, whereas the lectin, alternative, and terminal complement pathways were each assessed in three studies. Multiple studies investigated several complement pathways. The results were heterogeneous since several markers of complement activation spanning the classical (C2, C4a, C4b, and C1s-C1INH), alternative (Ba, iC3b, and Factor D), and terminal (C5bC6, C5a, C9, and TCC) pathways were elevated, whereas other markers were not significantly different (C3, C4, and C4d) between patients with/without long COVID. In addition, markers spanning the lectin complement pathway (MBL, and MASP1-C1INH) were not significantly different between individuals with and without long COVID. Conclusions: The current evidence suggests potential long-lasting complement system dysregulation in individuals with long COVID, although the clinical significance remains controversial, due to heterogenous findings. Specific post-COVID symptom clusters, such as fatigue, dyspnea, or brain fog, have been linked to a distinct pattern of complement dysregulation. Substantial methodological heterogeneity, including differences in follow-up periods, complement markers, assessment methods, and control groups, along with the small number of available studies, underscores the need for further research to clarify the mechanisms linking complement dysregulation to long COVID. Full article

Background/Objectives: Implant-supported rehabilitations using the All-on-4 concept represent a viable treatment option for completely edentulous patients. The guided surgery software allows for the performance of a flapless computer-guided surgery with similar results to those achieved through a flap surgery. This study aimed to evaluate the long-term outcomes of complete edentulous implant-supported rehabilitations using an All-on-4 arrangement, following a computer-guided protocol. Methods: A total of 111 patients (68 females, 43 males) with an average age of 60.9 years ± 9.67 years were treated. The primary outcome measures were implant and prosthetic survival. Secondary outcome measures were marginal bone loss (MBL) and the incidence of mechanical and biological complications. Results: Thirty-nine patients were lost to follow-up. Thirty-seven implants and five prostheses failed, rendering a 92.5% implant cumulative survival rate and a 96.2% prosthetic survival rate at 12 years. The average MBL per implant was 1.19 ± 1.16 mm, with 1.26 ± 1.33 mm for axial implants and 1.12 ± 0.95 mm for tilted implants at 10 years. The incidence rate of mechanical complications at the patient level was 90.1% for provisional prostheses and 55.9% for definitive prostheses. The rate of biological complications was 14.3% at the implant level. Conclusions: Full-arch rehabilitations following an All-on-4 implant arrangement and assisted by a computer-guided protocol may be a viable alternative for patients with edentulism/hopeless teeth in the long term. Full article

Postoperative delirium (POD) is a frequent and serious complication among elderly surgical patients. Despite its clinical relevance, reliable biomarkers for early identification and pathophysiological insight remain limited. Recent evidence implicates systemic immune activation and complements dysregulation as contributors to cognitive decline after surgery. This study investigated the association between perioperative levels of selected complement pathway proteins and both the incidence and severity of POD. Methods: We performed a secondary analysis of 22 patients aged ≥ 60 years from the prospective CONFESS cohort undergoing elective spine surgery. Complement proteins (C1q, C2, C4), mannose-binding lectin (MBL), Factor D [FD], Factor B [FB], Factor I [FI] were quantified from blood samples collected at baseline, preoperatively, and on postoperative days 1 and 2. POD was assessed using the Nursing Delirium Screening Scale (Nu-DESC) and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Delirium severity was rated with the Confusion Assessment Method–Severity (CAM-S) scale. Associations were tested using univariate and multivariate regression analyses. Preoperative levels of FD and C2 were significantly elevated in patients who developed POD (FD: p = 0.023; C2: p = 0.044), while C4 levels trended lower. FD remained an independent predictor of POD in multivariate regression (p = 0.049), although cognitive performance was the only significant predictor when adjusted for surgery duration. Delirium severity was associated with perioperative reductions in C1q, FI, and FB and with increased MBL levels, explaining up to 43% of CAM-S score variance. These findings highlight the role of complement activation—particularly FD, C2, MBL—in the development and clinical expression of POD. Complement profiling may offer a novel approach for risk stratification and therapeutic targeting in perioperative neurocognitive disorders. Full article

Background: Hepatitis B vaccination is the most effective strategy for preventing chronic hepatitis B virus (HBV) infection; however, interindividual variability in vaccine-induced antibody responses remains a significant challenge in the field. Innate immune components, particularly lectin complement pathway proteins such as mannose-binding lectin (MBL), mannose-associated serine protease 1 (MASP-1), and mannose-associated serine protease 2 (MASP-2), may contribute to this variability in outcomes. This study aimed to evaluate the association between serum MBL, MASP-1, and MASP-2 levels, birth weight, and humoral response to hepatitis B vaccination in infants. Methods: This single-center prospective observational study included 37 term infants who received hepatitis B vaccinations at birth, 1 month, and 6 months of age according to the national immunization schedule. Venous blood samples were collected at month 6, before, and month 7 after the 3rd vaccine dose. Serum MBL, MASP-1, MASP-2, and antiHB levels were measured using commercial ELISA and chemiluminescence assays. Data were analyzed using non-parametric statistical tests and Spearman’s correlation analysis. Results: AntiHB levels increased significantly following vaccination (median Pre-3rdVac: 125.8 mIU/mL; Post-3rdVac: 609.7 mIU/mL; p < 0.001). MASP-1 concentrations also showed a significant Post-3rdVac increase (median Pre-3rdVac: 809.52 ng/mL; Post-3rdVac: 1133.93 ng/mL; p = 0.019). Birth weight was positively correlated with both MASP-1 levels (r_s = 0.492, p = 0.004) and changes in MASP-1 concentrations (r_s = 0.524, p = 0.002) after the third dose. In addition, MASP-1 levels were positively associated with antiHB levels (r_s = 0.385, p = 0.030) and Post-3rdVac antiHB titers (r_s = 0.493, p = 0.004). In contrast, serum MBL and MASP-2 concentrations were not significantly associated with antiHB levels before or after vaccination. Conclusions: MASP-1, but not MBL or MASP-2, is associated with the magnitude of the antibody response to hepatitis B vaccination in infants. These findings suggest that specific components of the lectin pathway may influence vaccine-induced immunity, independent of MBL. Further large-scale studies incorporating genetic and functional analyses are warranted to clarify the mechanisms by which lectin pathway proteins shape hepatitis B vaccine response. Full article

Little is known about the effects of orthodontic loading on dental implants used for orthodontic anchorage in patients with Stage IV periodontitis. This retrospective case–control study included 58 dental implants in 24 patients with treated Stage IV periodontitis. The dental implants were used for both chewing function and orthodontic anchorages. The outcome measures included peri-implant marginal bone loss and peri-implantitis. Pair t-test and Wilcoxon rank-sum test were used to analyze the impact of implants as orthodontic anchorage on marginal bone loss (MBL) and peri-implantitis. No implants were lost during the 17-year follow-up. There was no statistically significant difference in the MBL and incidence of peri-implantitis between implants used as orthodontic anchorage and non-anchorage controls. (p > 0.05). Poor oral hygiene (p = 0.05), one-piece implants (p = 0.05) and implants with a keratinized mucosa < 2 mm (p = 0.015) were associated with a higher risk of peri-implantitis. Results from the present long-term study indicated that dental implants could be successfully used as orthodontic anchorage in periodontal compromised patients. Full article

Recycled wastewater is vital for the circular economy, especially on water-scarce islands. This study explored the presence of Carbapenem-Resistant Enterobacterales and other emerging pathogens in irrigation water on four Canarian Islands, applying a One Health perspective. Using membrane filtration and MALDI-TOF mass spectrometry, 69 bacterial isolates were identified. The findings revealed that 78% were Gram-negative bacilli like Pseudomonas aeruginosa, Acinetobacter spp., Enterobacteriaceae, etc., while 22% were Gram-positive bacteria, including Enterococcus spp. The main mechanisms of carbapenem resistance in Pseudomonas spp. and Acinetobacter spp. were oxacillinases, followed by metallo-β-lactamases (MBL). In Enterobacteriaceae, characterization of carbapenemase types was less frequent, with oxacillinase 48 (OXA-48) being the most prevalent. The detection of multidrug-resistant organisms in recycled wastewater highlights an urgent need for routine microbiological monitoring in water management to protect both public health and agricultural sustainability. Full article

Background/Objectives: Edentulism represents a major public health challenge, causing disorders of social, psychological and biological origin. Full-arch implant-supported restorations represent a viable alternative to mitigate this problem. This study aimed to evaluate immediate implant-supported restorations for the rehabilitation of the edentulous maxilla using four implants and distal implant tilting between 15 and 20 years. Methods: A total of 740 patients were included (women: 440; men: 300; average age: 55.3 years) rehabilitated with 740 prostheses, supported by 2960 dental implants. The primary outcome measure was prosthetic/implant cumulative survival and success (CSurR;CSucR). Secondary outcome measures included marginal bone loss (MBL), and the incidence of complications was evaluated as a secondary outcome measure. The outcomes were evaluated at 15 and 20 years. Results: In total, 287 patients (38.8%) with 1148 implants (38.8%) were lost to follow-up. A total of 170 implants (5.7%) in 101 patients (13.6%) failed, resulting in an implant CSurR and CSucR of 90.7% and 84.6%, respectively, after up to 20 years of follow-up. The prosthetic success rate was 98.1%. The average MBL was 1.07 mm ± 1.38 mm and 1.46 mm ± 1.56 mm at 15- and 20-years, respectively. Mechanical complication incidence was 78.5%, occurring in 581 patients (provisional prostheses: n = 448, 60.5%; definitive prostheses: n = 374, 50.5%). Biological complications occurred in 449 implants (15.2%) in 260 patients (35.1%). Biological complications and smoking habits were major risk indicators. Conclusions: Considering the study limitations, it can be concluded that the current rehabilitation concept is a viable treatment option in the long term, with mechanical and biological maintenance being necessary throughout the patients’ lives. Full article

The skin of turtles, particularly aquatic species, can harbor a diverse range of bacteria, including Citrobacter species, which are recognized as causative agents of Septicemic Cutaneous Ulcerative Disease. Consequently, turtles may act as reservoirs of pathogenic and multidrug-resistant bacteria, posing a potential public health concern. This case-based study investigated the presence of Citrobacter spp. in a loggerhead sea turtle (Caretta caretta) housed at the Livorno Aquarium, Italy. Nine swabs were collected from skin lesions (plastron, carapace, nuchal mass), the oral cavity, and the cloaca. The isolated strains were identified by MALDI-TOF MS and tested for their susceptibility to 12 antimicrobials, belonging to eight antimicrobial classes, by the disc diffusion method. Isolates were investigated genotypically for extended-spectrum-β-lactamase (ESBL) bla_CTX−M, bla_TEM, bla_SHV, bla_PER, and metallo-β-lactamase (MBL) bla_IMP, bla_OXA−48, bla_VIM, bla_NDM, bla_GES genes. Biofilm production ability was also evaluated. Fifteen Citrobacter spp. strains were recovered from the analyzed samples. Complete resistance was recorded for ampicillin, followed by high levels of resistance to imipenem, tetracycline and piperacillin-tazobactam. Worryingly, 86.7% were classified as multidrug-resistant. The most common ESBL-genotype combination was bla_SHV and bla_PER genes (60%), while the most frequently detected MBL gene was bla_NDM (46.7%), followed by bla_GES (40%). Most isolates were classified as weak biofilm producers (80%). The findings of this study demonstrate the presence of Citrobacter spp., an opportunistic pathogen, with a notable prevalence of multidrug-resistant strains carrying beta-lactamase-encoding genes, in a loggerhead sea turtle in Italy, across both lesioned and healthy anatomical sites. Full article

Serum lectins in vertebrates play crucial roles in innate immunity as recognition molecules for pathogen-associated molecular patterns (PAMPs). In mammals, two major lectins, mannose-binding lectin (MBL) and ficolin, both containing N-terminal collagen-like domains, activate the lectin pathway of complement. While MBL and ficolin recognize distinct PAMPs, their counterparts in teleosts are less understood. To date, MBL and galactose-binding lectin (GalBL) have been identified in teleosts, but the presence of ficolin remains unclear. In this study, we purified a 31-kDa serum lectin from common carp that displayed carbohydrate-binding specificity similar to that of mammalian ficolin. Unexpectedly, this lectin lacked an N-terminal collagenous domain and showed the highest similarity to mammalian microfibril-associated glycoprotein 4 (MFAP4), suggesting that the lectin is distinct from fibulin. Biochemical analyses revealed that carp MFAP4-like lectin (MFAP4Lec) protein forms a hexamer in serum, specifically binds GlcNAc and GalNAc, and recognizes the fish pathogen Vibrio anguillarum. The binding was competitively inhibited by GlcNAc but not by EDTA, indicating Ca²⁺-independent recognition. These findings suggest that MFAP4Lec functions as a novel serum lectin in teleost fish, serving as a recognition molecule for bacterial pathogens in innate immunity. Full article

Background/objectives: Zirconia dental implants are increasingly recognised as an alternative to titanium implants due to their biocompatibility and aesthetics. Initially developed as one-piece systems, zirconia implants have evolved into two-piece designs with different platform levels; however, comparative data on their primary and secondary stability– particularly as assessed by resonance frequency analysis (RFA)—and marginal bone dynamics remain limited. This case series aimed to evaluate the implant stability and marginal bone changes of two-piece zirconia implants with bone-level (BL) and tissue-level (TL) platforms in patients missing maxillary premolars. Methods: Thirteen zirconia implants (n = 13; 7 BL, 6 TL; Z5-TL/Z5-BL, Z-Systems, Switzerland) were placed in 11 patients with healed ridges. The implant stability quotient (ISQ) was measured immediately after insertion and before prosthetic loading. Lithium disilicate crowns were cemented after four months, and follow-ups were conducted for an average of 35 months (SD = 12). Results: Initial ISQ values ranged from 73 to 79, increasing to 76–84 at 3–4 months, indicating high implant stability for both BL and TL implants. The extent of marginal bone loss (MBL) after two years was greater around BL implants (mean 0.46 mm) compared to TL implants (mean 0.2 mm), although probing depths and bleeding on probing remained minimal in both groups, with only one TL implant showing gingival recession. Conclusions: Over a short observation period, two-piece zirconia implants with tissue-level platforms appeared to demonstrate superior marginal tissue stability. Further, larger-scale controlled studies are required to confirm these preliminary observations. Full article

Ceftazidime-avibactam (CA) and CA plus aztreonam (ATM) are the preferred treatment options for KPC and MBL carbapenemase-producing Enterobacterales infections (CPEis). All episodes of monomicrobial CPEis in immunosuppressed patients (IPs) admitted from May 2019 to November 2024, who received definitive antibiotic therapy (AT) with CA or CA + ATM for at least 72 h, were prospectively included. Bacteremic episodes (BEs) and non-bacteremic episodes (NBEs) were compared. Logistic regressions adjusted by propensity score were used to identify variables associated with 30-day overall mortality. In total, 82 CPEis were included (38 NBEs and 44 BEs). BEs more frequently occurred in hematological malignancies (52.3% vs. 15.8%, p = 0.0006), while NBEs were more commonly observed in solid organ transplantation (73.7% vs. 34.1%, p = 0.001). K. pneumoniae was the main isolated microorganism; KPC-CPE was the most common resistance mechanism in both groups, followed by MBL-CPE. The 7-day clinical response, 30-day overall and infection-related mortality between NBEs and BEs were 92.1% vs. 88.6%, p = 0.59, 10.5% vs. 27.3%, p = 0.09, and 2.6% vs. 13.6%, p = 0.11. Septic shock, OR 6.5, 95% CI, 1.58–26.72 (p = 0.01), and refractory malignancy, OR 5.6, 95% CI, 1.03–30.14 (p = 0.046), were associated with 30-day mortality, whereas BEs were not, OR 1.5, 95% CI, 0.36–6.2 (p = 0.56). CPEis in both NBE and BE IPs who received definitive AT with CA or CA + ATM correlated with a high rate of 7-day clinical response and low 30-day infection-related mortality. Underlying malignancy and disease severity were associated with 30-day overall mortality. Regional knowledge of bacterial antibiotic resistance enables the implementation of individualized AT to improve patient survival. Full article

Soil analysis is fundamental to sustainable agriculture; however, traditional laboratory methods are time-consuming, expensive, and environmentally hazardous. Spectroscopy techniques, particularly Near-Infrared (NIR), have gained considerable attention because they require minimal sample preparation, no chemicals, and predict multiple soil properties with a single scan. However, selecting appropriate equipment remains critical, as previous studies have reported inconsistent performance between conventional Near-Infrared (NIR) spectroscopy and advanced Fourier-Transform Near-Infrared (FT-NIR) spectroscopy. Therefore, this study aimed to compare the predictive performance of conventional NIR and advanced FT-NIR spectroscopy for sixteen soil properties. Soil samples (n = 567) were collected from different land-use types across South Korea at a depth of 0–20 cm and analyzed using laboratory methods and spectroscopy techniques. Five models, including partial least squares regression (PLSR), Cubist, support vector machine (SVM), random forest (RF), and memory-based learning (MBL), were evaluated using 15-fold cross-validation to assess prediction accuracy. Overall, conventional NIR spectroscopy yielded consistently higher accuracy for all soil properties than FT-NIR. Strong predictive accuracy was achieved for EC (R² = 0.84), OM (R² = 0.84), avl. P (R² = 0.77), TN (R² = 0.84), and CEC (R² = 0.76). In contrast, FT-NIR provided good prediction accuracy only for Ex. K (R² = 0.72) and TN (R² = 0.84). The average performance of NIR (R² = 0.67) outperformed FT-NIR spectroscopy (R² = 0.63) across all soil properties. These findings demonstrate that, despite their lower spectral resolution, NIR spectra provide robust predictive capability across a wide range of soil properties, which can significantly reduce the investment cost of advanced equipment such as FT-NIR for routine soil analysis. Full article

Background/Objectives: Metallo-β-lactamase (MBL)-producing Gram-negative bacteria represent a growing global health threat due to their broad resistance to β-lactam antibiotics, including carbapenems, which severely limits treatment options. This study aimed to evaluate the in vitro synergistic activity of fosfomycin (FOS) in combination with selected older and newer antimicrobials against MBL-producing Klebsiella pneumoniae and Pseudomonas aeruginosa. Methods: Synergistic interactions were assessed using agar dilution checkerboard on 42 MBL-producing clinical isolates (22 K. pneumoniae, 20 P. aeruginosa) and confirmed using time-kill assays with selected isolates. FOS was tested in combination with colistin (COL), ceftazidime–avibactam (CAZ-AVI), meropenem (MER), amikacin (AMI), aztreonam (AZT), aztreonam–avibactam (AZT-AVI), or cefiderocol (FDC). Results: Most FOS combinations exhibited additive or synergistic effects against clinical isolates. Synergy rates reached 72.7% for the FOS+CAZ-AVI combination (K. pneumoniae) and 65.0% for the FOS+COL combination (P. aeruginosa). An asymmetric synergistic interaction was identified for FOS+CAZ-AVI, with FOS enhancing the activity of CAZ-AVI more markedly than vice versa, especially in K. pneumoniae. Time-kill assays on selected isolates confirmed synergistic and bactericidal activity of FOS+CAZ-AVI and FOS+COL, and showed that bacterial regrowth observed with FOS, CAZ-AVI, and COL alone was suppressed in combination therapy. Conclusions: FOS-based combinations, particularly with CAZ-AVI and COL, demonstrated potent synergistic activity against MBL-producing K. pneumoniae and P. aeruginosa, supporting their potential utility in rational combination therapies for infections due to MBL-producing bacteria. Full article

Background: Marginal bone loss (MBL) is a condition leading to implant loss and treatment failure. MBL is one of the main complications in dental implantology. The aim of this research is to show the method that can predict bone loss around implants and protect patients from implant loss. Methods: A total of 1026 intraoral standardized radiographs of dental implants were included in this study. A total of 2052 peri-implant jawbone image samples were analyzed in MaZda 4.6 software. A new scale was calculated and described. MBL was measured, and groups of patients were compared. Results: After 3 months of functional loading, the Corticalization Index (CI) was calculated to be 210.70 ± 149.78 and increased after 60 months to 277.88 ± 198.78. In the 60-month observation, MBL was 0.85 mm ± 1.29 mm, and it has been noted that low MBL is associated with CI lower than 300, high MBL with CI higher than 500, and critical high MBL appeared when CI was higher than 1200. Conclusions: Authors created a new scale, and research showed that the specified CI in our scale may predict MBL around dental implants with a five-year forecast horizon. It allows us to implement specific treatment and protect implants from loss. Full article