The importance of saliva for oral health

Introduction: Saliva is an important biological fluid for the normal functioning of the oral system and thus for overall health. Over the years, many studies have shed light on the multifaceted importance of saliva in human health and that its function goes beyond simply keeping the oral cavity moist. One of the most striking properties of saliva is its ability to maintain the pH balance in the mouth. Objective: Determine the importance of the pH change in saliva in the face of different diseases that affect the oral cavity. Design: Systematic review of studies published from September 12 to 26, 2023 Data sources: PubMed Study selection: Five reviewers searched selected and extracted information from the selected articles. All pooled analyzes were based on random effects models. The protocol is available in PROSPERO 2014 registration code CRD42014009578 Results: Of 4,406 articles, 86 were included and 4,320 articles were excluded; therefore, the included terms were analyzed, obtaining 3 duplicates and 20 included that had the appropriate data.Introducción: La saliva es un fluido biológico importante para el funcionamiento normal del aparato bucal y, por tanto, para la salud en general. A lo largo de los años, numerosos estudios han arrojado luz sobre la importancia polifacética de la saliva en la salud humana y sobre el hecho de que su función va más allá del simple mantenimiento de la cavidad bucal húmeda. Una de las propiedades más llamativas de la saliva es su capacidad para mantener el equilibrio del pH en la boca. Objetivo: Determinar la importancia del cambio de pH en la saliva ante diferentes enfermedades que afectan a la cavidad bucal. Diseño: Revisión sistemática de estudios publicados del 12 al 26 de septiembre de 2023 Fuentes de datos: PubMed Selección de estudios: Cinco revisores buscaron seleccionaron y extrajeron información de los artículos seleccionados. Todos los análisis agrupados se basaron en modelos de efectos aleatorios. El protocolo está disponible en PROSPERO 2014 código de registro CRD42014009578 Resultados: De 4.406 artículos, se incluyeron 86 y se excluyeron 4.320 artículos, por lo que se analizaron los términos incluidos, obteniendo 3 duplicados y 20 incluidos que tenían los datos adecuados

Impact of the Thrombectomy Trials on the Management and Outcome of Large Vessel Stroke: Data From the Lyon Stroke Center

Introduction: Randomized trials (RT) have recently validated the superiority of thrombectomy over standard medical care, including intravenous thrombolysis (IVT). However, data on their impact on routine clinical care remains scarce.Methods: Using a prospective observational registry, we assessed: (1) the clinical and radiological characteristics of all consecutive patients treated with thrombectomy; (2) the outcome of all patients with M1 occlusion (treated with thrombectomy or IVT alone). Two periods were compared: before (2013–2014) and after (2015–2016) the publication of RT.Results: Endovascular procedures significantly increased between the two periods (N = 82 vs. 314, p < 0.0001). In 2015–2016, patients were older (median [IQR]: 69 [57-80]; vs. 66 [53-74]; p = 0.008), had shorter door-to-clot times (69 [47-95]; vs. 110 [83-155]; p < 0.0001) resulting in a trend toward shorter delay from symptom onset to reperfusion (232 [185-300]; vs. 250 [200-339]; p = 0.1), with higher rates of reperfusion (71 vs. 48%; p = 0.0001). Conversely, no significant differences in baseline NIHSS scores, ASPECTS, delay to IVT or intracranial hemorrhage were found. In 2015–2016, patients with M1 occlusion were treated with thrombectomy more often than in 2013–2014 (87 vs. 32%, respectively; p < 0.0001), with a significant improvement in clinical outcome (shift analysis, lower modified Rankin scale scores: OR = 1.68; 95% CI: 1.10–2.57; p = 0.017).Conclusion: Following the publication of RT, thrombectomy was rapidly implemented with significant improvements in intrahospital delay and reperfusion rates. Treatment with thrombectomy increased with better clinical outcomes in patients with M1 occlusion

MSSEG Challenge Proceedings: Multiple Sclerosis Lesions Segmentation Challenge Using a Data Management and Processing Infrastructure

International audienceThis proceedings book gathers methodological papers of segmentation methods evaluated at the first MICCAI Challenge on Multiple Sclerosis Lesions Segmentation Challenge Using a Data Management and Processing Infrastructure. This challenge took place as part of an effort of the OFSEP (French registry on mul- tiple sclerosis aiming at gathering, for research purposes, imaging data, clinical data and biological samples from the French population of multiple sclerosis sub- jects) and FLI (France Life Imaging, devoted to setup a national distributed e-infrastructure to manage and process medical imaging data). These joint ef- forts are directed towards automatic segmentation of MRI scans of MS patients to help clinicians in their daily practice. This challenge took place at the MICCAI 2016 conference, on October 21st 2016.More precisely, the goals of this challenge were multiple. It first aimed at evaluating state-of-the-art and advanced segmentation methods from the participants on a database following a standard protocol. For this, both lesion detection (how many lesions are detected) and lesion segmentation (how pre- cise the lesions are delineated) were evaluated on a multi-centric database (38 patients from four different centers, imaged on 1.5 or 3T scanners, each patient being manually annotated by seven experts from three different French centers, located in Bordeaux, Lyon and Rennes).This challenge was also the occasion to perform this advanced evaluation on a common infrastructure, provided by FLI. As such, challengers were asked to provide their pipeline as a Docker container image. After integration in the VIP platform, the challengers pipelines were then evaluated independently by the challenge organization team, the testing data and evaluation results being queried and stored in a Shanoir database. This infrastructure enabled a fair comparison of the algorithms in terms of running time comparison and ensuring all algorithms were run with the same parameters for each patient (which is required for a truly automatic segmentation). These proceedings do not include results of the evaluation, rather the evaluated methods descriptions. Evaluation results are available on the challenge website6 from the day of the challenge.As a conclusion note, the organizers of the challenge are welcoming new pipelines to be evaluated after the challenge itself. Interested teams may go on the challenge website to register their new method and evaluate it on our data

Analyse dynamique hebdomadaire du développement péri-veinulaire des lésions actives de SEP par imagerie de susceptibilité magnétique

International audienceIntroductionLe développement péri-veinulaires des lésions de SEP est un phénomène bien connu 0035, 0040 and 0045. Cependant, même si certains auteurs ont rapporté une sténose des veinules [4] intra-lésionnelles, aucune étude n’a caractérisé de manière dynamique ce phénomène. Dans cette étude, nous proposons d’analyser la cinétique ainsi que la localisation de la sténose des veinules dans les lésions actives de SEP.Matériel et méthodesUn suivi hebdomadaire a été mené pendant 8 semaines sur cinq patients non traités atteints d’une forme rémittente de SEP en IRM cérébrale 3 T 0055 and 0060 avec une exploration par imagerie de susceptibilité magnétique (SWI) et 3DT1 après injection de gadolinium. La sélection des lésions impliquait leur localisation sur une veine de diamètre supérieur à deux voxels et une prise de contraste comprise entre les première et dernière acquisitions exclues. Au total 3 lésions répondaient à ces critères. L’analyse des dynamiques d’interactions veine/lésion a été faite sur des régions d’intérêt (ROI) grâce à un algorithme7 regroupant automatiquement les voxels dont le signal évolue de manière similaire.RésultatsParmi les 3 lésions, un hypersignal transitoire a été mis en évidence en SWI au sein de la veinule centrale concomitant avec la prise de contraste, objectivé par une évolution commune du signal des voxels situés au cœur de la lésion (Fig. 1) Ces évolutions particulières du signal aux interfaces veine/lésion apparaissent au même moment ( and ) ou antérieurement (Fig. 4) à la prise de contraste.ConclusionNous avons mis en évidence une modification transitoire du signal à l’interface veine/lésion compatible avec une sténose des veinules synchronisée à la rupture de la barrière hémato-encéphalique, probablement en relation avec le manchon inflammatoire décrit histologiquement. L’idéal serait de pouvoir généraliser ces résultats sur un effectif plus grand même si cela pose des problèmes de faisabilité (de moins en moins de patients non traités, injections répétées de gadolinium)

MRI Assessment of Oxygen Metabolism and Hemodynamic Status in Symptomatic Intracranial Atherosclerotic Stenosis: A Pilot Study

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Multifocal arterial wall contrast – enhancement in ischemic stroke: A mirror of systemic inflammatory response in acute stroke

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Impact of Collateral Status on Neuroprotective Effect of Cyclosporine A in Acute Ischemic Stroke

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Conventional MRI radiomics in patients with suspected early- or pseudo-progression

International audienceAbstract Background After radiochemotherapy, 30% of patients with early worsening MRI experience pseudoprogression (Psp) which is not distinguishable from early progression (EP). We aimed to assess the diagnostic value of radiomics in patients with suspected EP or Psp. Methods Radiomics features (RF) of 76 patients (53 EP and 23 Psp) retrospectively identified were extracted from conventional MRI based on four volumes-of-interest. Subjects were randomly assigned into training and validation groups. Classification model (EP versus Psp) consisted of a random forest algorithm after univariate filtering. Overall (OS) and progression-free survivals (PFS) were predicted using a semi-supervised principal component analysis, and forecasts were evaluated using C-index and integrated Brier scores (IBS). Results Using 11 RFs, radiomics classified patients with 75.0% and 76.0% accuracy, 81.6% and 94.1% sensitivity, 50.0% and 37.5% specificity, respectively, in training and validation phases. Addition of MGMT promoter status improved accuracy to 83% and 79.2%, and specificity to 63.6% and 75%. OS model included 14 RFs and stratified low- and high-risk patients both in the training (hazard ratio [HR], 3.63; P = .002) and the validation (HR, 3.76; P = .001) phases. Similarly, PFS model stratified patients during training (HR, 2.58; P = .005) and validation (HR, 3.58; P = .004) phases using 5 RF. OS and PFS forecasts had C-index of 0.65 and 0.69, and IBS of 0.122 and 0.147, respectively. Conclusions Conventional MRI radiomics has promising diagnostic value, especially when combined with MGMT promoter status, but with moderate specificity. In addition, our results suggest a potential for predicting OS and PFS

Avoiding New Biopsies by Identification of IDH1 and TERT Promoter Mutation in Nondiagnostic Biopsies From Glioma Patients

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