Vassilis Karagiannis

Depression, heart rate variability, and exercise training in dialysis patients:

Background Functional limitations, altered cardiac autonomic activity, and psychological distress are known disorders in chronic hemodialysis (HD) patients, relating to increased morbidity and mortality. The aim of this study was to examine the influence of an exercise training program on emotional parameters and heart rate variability (HRV) indices, as well as to determine whether emotional stress contributes to autonomic dysfunction in these patients. Methods Forty-four HD patients were randomly assigned into group A (24 patients, aged 46.3 ± 11.2 years), who participated in a 1-year intradialytic exercise training program and group B (20 patients, aged 45.8 ± 10.8 years), who were used as controls. At baseline and a year after, measures of HRV were obtained for the estimation of standard deviation of RR intervals, the mean square successive differences, percentage of RR intervals differing by more than 50 ms from the preceding RR interval (pNN50), and low to high frequency components. Emotional parameters (Beck Depression Inventory – BDI and Hospital Anxiety and Depression Scale – HADS) were also assessed by validated questionnaires. Moreover, all patients performed a spiroergometric study for the estimation of VO2peak. Results At baseline, all measurements were similar in the two groups and remained almost unchanged after a year in group B. After a year of training, VO2peak increased from 16.79 ± 5.24 to 22.33 ± 4.90 ml/kg per min (P >0.001) in group A. Trained patients also showed an increase in standard deviation of RR intervals by 58.8% (P >0.001), the mean square successive differences by 68.1% (P >0.001), pNN50 by 23.5% (P >0.001), and a low to high frequency ratio by 17.3% (P >0.001). Finally, at the end of the study, group A showed a decrease in BDI score by 34.5% (P >0.001) and HADS by 23.9% (P >0.001). Canonical correlation revealed significant inverse correlation among depression (in BDI and HADS) and HRV indices before and after exercise training. Conclusion Cardiac autonomic modulation seemed to be sensitive to the experience of persistent depression in HD patients. Significantly, exercise training reduced emotional distress and concomitantly improved HRV.

Spectrophotometric analysis of coronal discolouration induced by grey and white MTA

AIM To evaluate the specific alterations in tooth colour with white and grey MTA when used to fill pulp chambers. METHODOLOGY Forty-five fully developed, intact, mandibular third molars were sectioned 1 mm below their cemento-enamel junction (CEJ). Their pulp chambers were chemo-mechanically debrided, and the specimens were randomly assigned into three groups: Group 1-white MTA (Angelus(™)), Group 2-grey MTA (Angelus(™)) and Group 3-negative control (unfilled). During the experimental period, specimens were immersed in vials containing distilled water up to the CEJ (37±1 °C). Spectral reflectance lines were recorded by utilizing a UV-vis spectrophotometer equipped with an integration sphere in the visual spectrum, at baseline, 1 week and 1, 2 and 3 months after placement of the materials. Data were transformed into values of the CIE L*a*b* colour system, and the corresponding ΔΕ values were calculated. The results were analysed using two-way mixed anova models, whilst pairwise comparisons were conducted with Bonferronis method at P < 0.05 level of significance. RESULTS Both types of MTA induced significant decreases in L*, a* and b* values. The colour change was greater with grey MTA. Grey MTA led to clinically perceptible crown discolouration after 1 month, whilst the total colour change caused by white MTA exceeded the perceptible threshold for the human eye after 3 months. CONCLUSIONS The application of both grey and white MTA formulations induced a decrease in lightness and reduction in redness and yellowness in teeth. The present findings suggest that application of grey MTA in the aesthetic zone should be avoided, whilst white MTA should be used with caution when filling pulp chambers with the materials.

Spectrophotometric analysis of crown discoloration induced by MTA- and ZnOE-based sealers

Crown discoloration can be induced by root canal sealer remnants following root canal treatment. Objective: The aim of this study was to evaluate chromatic alterations in human tooth crowns induced by a Mineral Trioxide Aggregate-based sealer (MTA Fillapex® and a commonly used ZnOE-based sealer (Roth-811). The tested null hypothesis was that the application of the materials did not induce clinically perceptible crown discoloration (Ho: CIE color difference ΔE<3.7). Material and Methods: Forty five fully developed, intact, mandibular third molars were sectioned 1 mm below the cemento-enamel junction. The pulp chambers were chemomechanically debrided via the cervical access. The specimens were randomly assigned into three groups Group 1: MTA Fillapex, Group 2: Roth 811, Group 3: Negative control (unfilled) and immersed in individually marked vials containing distilled water up to the cervix (37±1º C). The spectral reflectance lines were recorded by utilizing a UV-VIS spectrophotometer equipped with integration sphere in the visual spectrum at baseline, 1 week, 1 and 3 months after material placement. Data were transformed into values of the CIE L*a*b* color system and the corresponding ΔE values were calculated. Statistical analysis was performed using two-way mixed ANOVA models, at p=0.05 level of significance. Results: A statistically significant increase in a* and b* chromatic parameters of the MTA Fillapex Group was measured. However, ΔE values did not exceed the human eye perceptibility threshold (set at ΔE<3.7) during the experimental period (ΔEt3=2.88). In Roth-811 Group, a statistically significant decrease in L* and a statistically significant increase in a* and b* chromatic parameters was measured, during all observation periods. Resultant ΔE values exceeded the human eye perceptibility threshold after 1 week (ΔEt1=5.65). Conclusions: Application of MTA Fillapex in tooth crowns resulted in minimal color alterations, while Roth 811 induced severe discoloration, in vitro. It could be suggested that, in terms of aesthetics, the use of MTA Fillapex appears to be favorable.

Assessment of characteristic features and dental anomalies accompanying tooth transposition: A meta-analysis

INTRODUCTION The aim of this study was to investigate possible characteristic features and dental anomalies that accompany tooth transposition. METHODS Several electronic databases were searched. Hand searching was also performed to identify potentially relevant studies. Initially, 409 articles were retrieved (399 by electronic searching, 10 by hand searching). After applying specific exclusion criteria, 5 studies were eligible for this meta-analysis. Meta-analysis was performed by determining the marginal mean proportions and the 95% confidence intervals estimated by the random-effect model. Evaluation of heterogeneity was also done with Q and I(2) statistics. RESULTS The lack of high-validity studies of the characteristic features and dental anomalies of tooth transposition was noted. The analysis of the data of the studies showed that tooth transposition seems to occur more often unilaterally than bilaterally, with maxillary prevalence and no sex preference, and it is significantly unrelated to dental anomalies, such as congenitally missing teeth, peg-shaped or hypoplastic teeth, or impacted teeth. There might be an association with overretained deciduous teeth. CONCLUSIONS Tooth transposition is an isolated phenomenon rather than a syndrome. It occasionally can be accompanied by other characteristic features and dental anomalies, but without distinct associations.

Treatment of vibriosis in European sea bass larvae, Dicentrarchus labrax L., with oxolinic acid administered by bath or through medicated nauplii of Artemia franciscana (Kellogg): efficacy and residual kinetics

European sea bass larvae were challenged by bath with Listonella anguillarum strain 332A, 2.5×10(7) CFUmL(-1) for 1h. Fish either received no treatment or oral treatment with Artemia franciscana (Kellog) nauplii enriched with oxolinic acid, or bath treatments with oxolinic acid. Medication commenced 1day following challenge and was performed on days 1, 3 and 5 post-challenge at a dosage of 20mgL(-1) for 2h for bath treatments, while two doses each of 750 nauplii per fish were administered daily for five consecutive days in oral treatments. Cumulative mortality reached 96% for the unmedicated challenged group, 32% in the group receiving bath treatments and 17% in the group receiving medicated nauplii. Pharmacokinetic parameters of oxolinic acid were calculated in sea bass larvae, for both treatments. Steady-state concentrations of oxolinic acid of 48.0 and 75.2μgg(-1) were achieved for bath treatment and oral treatment, respectively, while the elimination half-life was calculated to be 25.1h for bath treatment and 21.7h for oral treatment.

Treatment duration and gingival inflammation in Angle’s Class I malocclusion patients treated with the conventional straight-wire method and the Damon technique: a single-centre, randomised clinical trial

Objective To compare the duration of orthodontic treatment and Gingival Index (GI) scores in Class I malocclusion patients treated with a conventional straight-wire method (CG) or the Damon technique (DT). Design Two-arm, parallel, randomised clinical trial Setting A postgraduate orthodontic clinic Participants Patients with a balanced facial profile, a full permanent dentition and Angles Class I malocclusion with moderate crowding. Methods The primary outcome was the duration of orthodontic treatment in months. GI scores throughout treatment were secondary outcomes and the PAR index was also assessed. Randomisation was accomplished using a table of random numbers and the allocation was concealed in sequentially numbered and opened, opaque, sealed envelopes. Blinding was applicable for PAR assessment only. Comparison of data between groups was performed with appropriate tests for independent samples. Results Twenty-two patients were randomly allocated to treatment in a 1:1 ratio to either CG or DT group. Age at the start of treatment, initial PAR index and GI scores were similar between groups. All patients completed the study, but the total duration of orthodontic treatment was almost half of the initial assumption. No statistically significant differences were observed in treatment duration (CG: Mean ( x ̄ ) = 14.5 months, Standard Deviation (SD) = ±3.03; DT: x ̄ = 12.25 months, SD = ±2.93; 95% Confidence Interval: −0.40 to 4.90; P = 0.093; t-test). The two groups did not differ statistically regarding the GI scores during the observational period. No serious harms were observed other than gingival inflammation associated with oral biofilm accumulation. Conclusions The present study did not reveal statistically significant differences between the compared, conventional straight-wire method and Damon technique-treated, Angles Class I malocclusion groups regarding total treatment duration and GI scores.