Search Results (317)

Periodontal disease is a progressive inflammatory condition frequently diagnosed in dogs, particularly in small breeds such as Yorkshire Terriers, Toy Terriers, Spitz, Toy Poodles and other breeds predisposed to rapid plaque and tartar accumulation. As the field of regenerative medicine becomes more popular, more and more attention is being paid to substances that promote tissue regeneration, one of which is platelet-rich plasma (PRP). PRP is an autologous blood-derived product rich in growth factors that stimulate tissue regeneration and modulate inflammation. This study aimed to evaluate the clinical effectiveness of PRP injections without additional activating agents in the management of stage 2–3 periodontitis in small-breed dogs. Forty-two adult dogs (Yorkshire Terriers, Toy Terriers, Pomeranians, Toy Poodles, and Havanese) were enrolled and divided into two groups: PRP (n = 30) and control (n = 12). Following standard dental prophylaxis, the PRP group received gingival, submucosal, and periodontal pocket injections of PRP (0.1 mL per site). Periodontitis stage, gingival index, periodontal pocket depth, and horizontal bone loss were evaluated at baseline and 30 days post-treatment. PRP therapy significantly improved all evaluated parameters (p < 0.05). The gingival index decreased threefold, periodontal pocket depth was reduced twofold, and horizontal bone loss decreased by more than twofold compared with baseline and controls. No adverse reactions, discomfort, or postoperative complications were observed. The administration of non-activated PRP as an adjunct to dental cleaning significantly enhances soft and hard tissue regeneration in small-breed dogs with stage 2–3 periodontitis. PRP therapy represents a safe, minimally invasive, and effective regenerative approach for improving periodontal health in routine veterinary dentistry. Full article

Background: Magnetic resonance imaging (MRI) plays an increasingly important role in the evaluation of scrotal and penile disorders, complementing ultrasonography in cases where findings are equivocal or complex. With its superior soft-tissue contrast, multiplanar capability, and advanced functional sequences, MRI provides unparalleled anatomic and tissue characterization across a wide range of male genital pathologies. Summary: This review summarizes current clinical applications of MRI in scrotal and penile imaging and discusses its diagnostic value, protocol optimization, and interpretive features. In scrotal pathology, MRI accurately differentiates torsion, trauma, infection, and neoplasms, aiding in the distinction between benign and malignant testicular lesions and supporting testis-sparing management. Quantitative diffusion and perfusion metrics further refine lesion characterization. In andrology, MRI biomarkers such as apparent diffusion coefficient (ADC), magnetization transfer ratio (MTR), and proton spectroscopy serve as promising non-invasive indicators of spermatogenic activity in male infertility. In penile imaging, MRI enables precise local staging of carcinoma, assessment of plaque morphology and activity in Peyronie’s disease, evaluation of tissue viability in priapism, and detection of prosthesis-related complications. Conclusions: MRI has become an essential problem-solving tool in the assessment of scrotal and penile diseases, enhancing diagnostic confidence and surgical planning. Future directions include protocol standardization, quantitative parameter validation, and the integration of radiomics and artificial intelligence to improve reproducibility and clinical impact. Full article

The use of imaging during percutaneous coronary intervention (PCI) can improve the outcomes by giving key information in every phase of the procedure. It can improve the knowledge of plaque composition thus helping the subsequent technical strategy; it can precisely define the measure of the stent to implant; it can assess in detail the correct positioning of the stent (apposition, expansion, and full coverage of the atherosclerotic plaque); it helps in recognizing the complications that may occur after stenting (e.g., edge dissection or tissue/thrombus protrusion in the stent area). Further, it could help evaluation for both diagnostic and therapeutic purposes of angiographic unknown or questionable findings [e.g., spontaneous coronary artery dissection (SCAD), characterization of mycotic aneurysm and pseudoaneurysm]. In the follow up phase, the use of intracoronary imaging may significantly improve the understanding of the mechanisms leading to the procedural failure. What this review adds is to describe the similarities and differences between intravascular ultrasound (IVUS) and optical coherence tomography (OCT) technologies, to highlight the evidence supporting their utility to improve PCI outcomes, to give practical advice and tools on daily interventional routine, to show a point of view on future perspectives and integration with artificial intelligence (AI). Full article

Coronary artery disease remains the leading cause of cardiovascular morbidity and mortality worldwide, affecting millions of individuals each year. Coronary artery calcification is a common finding in patients with advanced atherosclerosis and represents an important determinant of procedural success during percutaneous coronary intervention. Severe calcifications are associated with increased procedural complexity and elevated complication rates due to challenging lesion preparation, suboptimal stent expansion, and less favorable long-term clinical results. This review summarizes the present understanding of vascular calcification mechanisms, discusses relevant diagnostic imaging modalities, and describes current plaque modification techniques used to optimize procedural outcomes. Methods such as rotational, orbital, and laser atherectomy, as well as specialized balloon technologies and intravascular lithotripsy, are discussed with regard to their mechanisms of action, clinical effectiveness, and safety profiles. Particular emphasis is placed on the integration of advanced imaging for precise lesion assessment, improved patient selection, and the use of combination strategies in complex cases. Finally, emerging technologies and future directions are highlighted, with the goal of enhancing procedural safety, device deliverability, and treatment outcomes in the evolving field of interventional cardiology. Full article

More than a century ago, bacteriophages (phages) were discovered as entities that could both replicate and dramatically reduce bacterial culture turbidities. By the late 1940s, phage impact on broth turbidity was being studied using electronic detectors. This review examines such turbidimetric, also known as colorimetric or optical density means of studying phage biology. The focus is especially on relatively rapid and higher throughput phenotypic phage characterization versus methods that rely instead on phage plaques, spots, or genotype determinations. Topics covered include (i) the most probable number method along with Appelmans’ approach, (ii) estimation of phage growth parameters including especially that of phage lysis timing, (iii) consideration of lysis inhibition as a complicating factor, (iv) phage titering based on degrees of optical density change, (v) detection of both lysis from without and resistance to lysis from without, (vi) phage host-range determination, and (vii) study of post-lysis culture grow back, that is, of bacterial evolution of phage resistance. Based on over 30 years of experience using and studying optical density approaches to the exploration of broth-culture phage biology, the author takes a critical look at both the benefits and limitations of this increasingly common approach to phage biological characterization. Full article

Background: Diabetic neuropathy affects almost half of diabetic patients, yet the relative contributions of metabolic, vascular and clinical factors remain controversial. We aimed to investigate which risk factors are more associated with reduced corneal nerve fiber length (CNFL). Methods: This is a cross-sectional study of 30 patients with type 2 diabetes. We assessed metabolic parameters (HbA1c, lipids), vascular measurements (Doppler ultrasonography of carotid and ophthalmic arteries, central vessel density measured by optical coherence tomography angiography), and corneal epithelial thickness. We explored the data using network analysis, then applied penalized mixed-effect regression (in which $\beta$ represents the standardized coefficients with mean 0 and unit standard deviation), followed by generalized additive models and polynomial transformations. Results: Penalized regression identified vascular parameters as dominant predictors: carotid plaques ($\beta$ = −0.609) and intima-media thickness ($\beta$ = −0.574) showed the strongest associations with CNFL. Traditional metabolic markers including HbA1c failed to meet selection thresholds. Bifurcation velocity ($\beta$ = −0.313) and corneal sensitivity measures ($\beta$ = 0.278–0.135) were also significant. The non-linear modeling showed complex vascular–structural interactions. Conclusions: Vascular compromise, particularly carotid disease, had the highest association with CNFL in our cohort. Thus, our study reports a higher effect of vascular parameters than HbA1c in patients with a longer history of diabetes. This may reflect the progression of diabetic complications, where initial metabolic insults are followed by vascular pathology as the primary driver of end-organ damage. Our findings highlight the need for carotid artery screening in diabetic patients for a better estimation of the neuropathy risk. Full article

Background/Objectives: Fully digital workflows used in implant dentistry have been evolving to improve rehabilitation times and patient satisfaction. More studies are necessary for full scientific validation. The aim of this study was to evaluate the 6-month outcome of implant-supported fixed prostheses for full edentulism rehabilitation using OnX Tough 2 resin (SprintRay) and the Pro 2 (SprintRay) 3D printer following the All-on-4 concept. Methods: This study included 16 patients (10 female, 6 male) with 20 implant-supported fixed full-arch prostheses following the All-on-4 concept (10 rehabilitations for each stackable guide and photogrammetry protocols). Primary The primary outcome measure was implant and prosthetic survival. The secondary outcome measures included manufacturing issues, prosthetic passive fit, marginal bone loss (MBL), mechanical and biological complications, modified plaque and bleeding indexes, pocket depths, patient subjective evaluation, and the Oral Health Impact Profile. Results: No patients were lost to follow-up. Two prostheses failed and 2 two implants were lost, resulting in a cumulative survival rate of 90% and 97.5% at 6 months for prostheses and implants, respectively. The mean MBL was 0.31 mm ± 0.52 mm at 4 months. The mechanical complications rate was 50% at patient level. One patient (6.3%) experienced one biological complication. The grades regarding “comfort of prostheses in the mouth” and “overall chewing feeling” were 9.35 ± 1.29 and 8.79 ± 1.67 out of 10, respectively. The mean total sum of the OHIP-14 was 1.61 out of 56. Conclusions: Implant-supported full-arch rehabilitations with fixed prostheses following the All-on-4 concept, through a fully digital workflow protocol, are a viable option in the short term. Full article

Intracoronary optical coherence tomography (OCT) is a highly accurate and sensitive imaging tool capable of providing high resolution visualization of atherosclerotic coronary plaque morphology and microstructures in vivo. OCT has proven to be useful in clinical practice, particularly in percutaneous coronary intervention (PCI) guidance, assessment of stent-related complications, and elucidation of the pathobiological cause of acute coronary syndrome. Notably, OCT allows for the detection of specific plaque features (i.e., thin cap fibroatheroma, lipid-rich plaque, macrophage infiltration, healed plaques, microvessels, etc.) that are known to carry prognostic significance in the context of coronary artery disease (CAD). These insights may offer valuable information about the patient’s overall atherosclerotic background, potentially supporting more personalized secondary prevention strategies, including lifestyle modification and targeted pharmacologic therapies. Recently, the role of preventive PCI in plaques with high-risk features has also been investigated with promising—though still preliminary—results. In this narrative review, we primarily aim to discuss studies evaluating the prognostic value of OCT-identified coronary plaque microstructures. We also assessed potential therapeutic implications in the management of patients with CAD. Full article

Calcified coronary lesions remain a challenge in percutaneous coronary intervention (PCI) in both situations of acute myocardial infarction (MI) and stable coronary syndrome. It significantly increases the risk of procedural complications due to difficulty in equipment delivery, balloon expansion, and stent delivery. Furthermore, stent thrombosis, dissection, perforation, and future in-stent restenosis occur more frequently in calcified coronary lesions, impacting repeat target vessel revascularization and increasing the risk of future MI. With intracoronary imaging (intravascular ultrasound and optical coherence tomography), peri-procedural success for treating calcified lesions has increased significantly. Different modalities of calcium modification techniques have since been introduced. This review will discuss the pathophysiology and phenotypes of calcium deposition in the coronary vessels, including eccentric calcified plaques and calcified nodules. We will also focus on calcium modification techniques and their mechanisms: (1) Balloon escalation technique, (2) intravascular lithotripsy, (3) orbital atherectomy, and (4) rotational atherectomy. We will focus on the strengths and limitations of each technique, based on current recommendations and expert consensus from SCAI. We will also provide contemporary evidence of each modality for treating different phenotypes of calcified lesions. In summary, this article provides a comprehensive review of current guidelines for optimizing the treatment of calcified coronary lesions in PCI. Full article

Background: Peripheral Artery Disease (PAD) of the lower extremities is a prevalent manifestation of atherosclerotic disease, significantly affecting individuals aged 55–70, with a global incidence of 4–12%. Major risk factors include smoking, diabetes mellitus, hypertension, dyslipidemia, and chronic kidney disease, all contributing to endothelial damage and subsequent plaque progression. This retrospective study examines the outcomes of endovascular treatment for TASC C and D lesions, which are complex cases that have historically required surgical intervention. Methods: From June 2022 to September 2023, 48 patients were analyzed, with a mean age of 67.48 years; 37.5% were female. Statins were administered to 64.6% of patients, and 93.8% received antiplatelet therapy. Endovascular procedures included balloon angioplasty, stenting, and the use of drug-eluting balloons (DEB), employing varying access routes, primarily via percutaneous approaches. Results: The study revealed a 12-month primary patency rate of 75.8% and a secondary patency rate of 95.5%, highlighting the effectiveness of follow-up interventions. Complications occurred in 10.4% of cases, with a perioperative mortality rate of 0%. Notably, 29.2% of patients required amputation, reflecting the severity of PAD. Conclusions: The outcomes demonstrate that endovascular treatment may be a viable alternative for managing TASC C and D lesions, offering satisfactory clinical outcomes and an acceptable safety profile. Continuous monitoring and interdisciplinary evaluations are essential for optimizing patient care and minimizing complications. As endovascular technologies advance, their role in treating severe peripheral arterial disease is likely to expand. Full article

Atherosclerosis is a widespread cardiovascular disease characterized by retention of atherogenic lipoproteins in the arterial wall and the onset of subclinical vascular inflammation; the development of atherosclerotic plaques; eventual narrowing of the arterial lumen and/or plaque disruption; and subsequent manifestation with stable ischemia or acute atherothrombotic events. Numerous cell types are implicated in atherogenesis. Monocytes/macrophages are considered pivotal participants in this complex process. They play a crucial role in the onset and augmentation of inflammation and greatly contribute to atherosclerotic plaque growth and destabilization. However, monocytes/macrophages are also essential for the resolution of inflammation and the stabilization of atherosclerotic lesions. In this regard, studies of the function of monocytes/macrophages in relation to this disease are of considerable interest to researchers, as the results can help to design new drugs aimed at preventing the development of atherosclerosis and its complications. This review presents current data on the classification and functions of monocytes/macrophages; discusses current hypotheses regarding the involvement of monocytes/macrophages in atherogenesis; and highlights existing gaps in evidence. This review is primarily aimed at readers with a background in clinical medicine who are interested in the involvement of monocytes/macrophages in atherogenesis. Full article

Intravascular imaging has revolutionized the assessment and management of coronary artery disease, providing unparalleled insights into plaque morphology, lesion severity, and percutaneous coronary intervention (PCI) optimization. This comprehensive review explores the current landscape of intravascular imaging, detailing the principles and clinical utility of intravascular ultrasound (IVUS) and optical coherence tomography (OCT). We discuss the role of these technologies in various clinical scenarios, ranging from stable coronary artery disease to acute coronary syndromes, emphasizing their ability to refine diagnostic accuracy and therapeutic decision-making. A key focus is placed on their application in identifying vulnerable plaques, a critical step in preventing adverse cardiovascular events. Furthermore, we highlight the role of intravascular imaging in guiding PCI, improving stent deployment, and reducing procedural complications. Finally, we explore emerging imaging modalities and technological advancements poised to further enhance coronary assessment, including hybrid imaging techniques. In addition to established modalities, this review examines emerging imaging technologies and the growing integration of artificial intelligence (AI) and hybrid imaging systems, which hold promise for automated plaque characterization, improved reproducibility, and enhanced decision support during PCI. By summarizing the latest evidence and future directions, this review aims to provide a comprehensive reference for clinicians and researchers seeking to optimize the use of intravascular imaging in contemporary cardiovascular practice. Full article

Intravascular imaging (IVI), particularly intravascular ultrasound (IVUS) and optical coherence tomography (OCT), addresses the intrinsic limitations of two-dimensional coronary angiography by offering high-resolution information regarding vessel and plaque morphology before percutaneous coronary intervention (PCI) as well as enabling accurate assessment of stent expansion and apposition after implantation. These anatomical insights can translate into improved procedural success and late clinical outcomes. The magnitude of benefit appears closely related to lesion morphology and procedural complexity. While angiographic guidance may be sufficient in straightforward anatomies, IVI assumes a pivotal role in complex disease subsets. IVUS, with its deeper tissue penetration, real-time imaging capability, and lack of need for contrast flushing, is particularly advantageous for large-vessel interventions, chronic total occlusions, and contrast-sparing strategies. In contrast, OCT, offering superior axial resolution, excels in characterizing plaque composition and in detecting stent-related complications. Hybrid IVUS-OCT catheters have the potential to integrate the complementary strengths of both IVI modalities, thereby streamlining procedural workflows and broadening clinical applicability. Although current guidelines endorse IVI use in anatomically complex coronary artery disease, real-world adoption remains low, largely influenced by operator proficiency, regional differences, and reimbursement arrangements. Further research is warranted to identify lesion subsets in which one modality confers clear clinical benefit and to delineate the threshold of procedural complexity at which IVI becomes cost-effective. Full article

Endurance exercise is widely recognized for its cardiovascular benefits, including improved longevity and metabolic health. However, excessive endurance training may lead to adverse cardiac adaptations, such as myocardial fibrosis, detected via late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR). This review examines the dual role of myocardial fibrosis in athletes—as a potential risk marker for life-threatening arrhythmias or a benign byproduct of physiological remodeling. While moderate exercise promotes beneficial cardiac hypertrophy, ultra-endurance athletes exhibit a 10–20% increase in ventricular size and mass, alongside elevated cardiac biomarkers post-exercise. Myocardial fibrosis, particularly in the left ventricle (LV), is associated with arrhythmias and sudden cardiac death, especially when presenting as a subepicardial/midmyocardial patchy pattern. Studies report that 22% of athletes with this pattern experienced malignant arrhythmias, underscoring its clinical significance. Conversely, fibrosis may also reflect adaptive remodeling in some cases, complicating its interpretation. The mechanisms underlying fibrosis in athletes remain unclear but may involve repeated cardiac stress, inflammation, or distinct atherosclerotic plaque dynamics. CMR is critical for detecting fibrosis, though differentiating pathological from physiological patterns requires careful clinical correlation. Risk stratification must consider LGE patterns, arrhythmia history, and symptoms. Despite concerns, elite athletes generally exhibit increased longevity, highlighting the complex interplay between exercise benefits and risks. Further research is needed to clarify fibrosis mechanisms, refine diagnostic criteria, and guide management strategies to ensure athlete safety while preserving the advantages of endurance training. Full article

Ceramic dental implants, particularly one-piece zirconia, offer a biocompatible and aesthetic alternative to titanium, with high strength and improved oral hygiene. By eliminating the implant–abutment micro-gap, they reduce bacterial accumulation because of their low plaque affinity and enhance stability. However, challenges remain, including alignment precision, limited retrievability, and sensitivity to mechanical stress. Misalignment can affect occlusal and functional outcomes, and zirconia’s rigidity complicates crown removal and modification. This case report explores the use of PEEK (polyether ether ketone) primary telescopic crowns to overcome these limitations, improving force distribution, enabling minor adjustments, and enhancing prosthetic retrievability in full-mouth zirconia restorations. A 62-year-old male patient seeking a fixed solution to replace removable dentures received 16 one-piece zirconia implants (eight per jaw). PEEK telescopic crowns were used over implant abutment copings, finalized with aesthetic zirconia bridges. The report details surgical and prosthetic procedures, along with a brief literature review on zirconia implants and PEEK applications. PEEK integration in telescopic prosthetic designs marks a notable advancement in prosthodontics. Its shock-absorbing, biocompatible, and stress-modulating properties make it valuable for implant-supported and hybrid restorations. As digital workflows advance, PEEK-based telescopic restorations may increasingly replace traditional metal-based solutions, improving long-term clinical outcomes. Further clinical research on a larger sample is needed. Full article