A Clinically Explainable AI-Based Grading System for Age-Related Macular Degeneration Using Optical Coherence Tomography

We propose an automated, explainable artificial intelligence (xAI) system for age-related macular degeneration (AMD) diagnosis. Mimicking the physician's perceptions, the proposed xAI system is capable of deriving clinically meaningful features from optical coherence tomography (OCT) B-scan images to differentiate between a normal retina, different grades of AMD (early, intermediate, geographic atrophy (GA), inactive wet or active neovascular disease [exudative or wet AMD]), and non-AMD diseases. Particularly, we extract retinal OCT-based clinical imaging markers that are correlated with the progression of AMD, which include: (i) subretinal tissue, sub-retinal pigment epithelial tissue, intraretinal fluid, subretinal fluid, and choroidal hypertransmission detection using a DeepLabV3+ network; (ii) detection of merged retina layers using a novel convolutional neural network model; (iii) drusen detection based on 2D curvature analysis; (iv) estimation of retinal layers' thickness, and first-order and higher-order reflectivity features. Those clinical features are used to grade a retinal OCT in a hierarchical decision tree process. The first step looks for severe disruption of retinal layers' indicative of advanced AMD. These cases are analyzed further to diagnose GA, inactive wet AMD, active wet AMD, and non-AMD diseases. Less severe cases are analyzed using a different pipeline to identify OCT with AMD-specific pathology, which is graded as intermediate-stage or early-stage AMD. The remainder is classified as either being a normal retina or having other non-AMD pathology. The proposed system in the multi-way classification task, evaluated on 1285 OCT images, achieved 90.82% accuracy. These promising results demonstrated the capability to automatically distinguish between normal eyes and all AMD grades in addition to non-AMD diseases.

Effect of dapagliflozin against NAFLD and dyslipidemia in type 2 diabetic albino rats: possible underlying mechanisms

OBJECTIVE

The aim was to investigate the effect of dapagliflozin on non-alcoholic fatty liver disease and dyslipidemia in type 2 diabetic rats by studying the histopathological structure of the liver and detecting possible underlying mechanisms for this impact by evaluating the potential anti-inflammatory action of dapagliflozin.

MATERIALS AND METHODS

100 albino rats were used in this work and divided into five equal groups: group I (Control group), group II (Control diabetic group), group III (was administered dapagliflozin, 0.75 mg/kg, p.o.), group IV (was administered dapagliflozin, 1.5 mg/kg, p.o.), and group V (was administered dapagliflozin, 3 mg/kg, p.o.).

RESULTS

In our study, the total body weight, liver weight, liver index, blood glucose level, insulin level, insulin resistance, total cholesterol, triglycerides, liver enzymes, IL-1 β, and MDA were significantly higher in the control diabetic group than the normal group. The dapagliflozin reduced all the above variables significantly in a dose-dependent manner compared to the control diabetic group (p-value = 0.001 for all).

CONCLUSIONS

Dapagliflozin may be a promising novel treatment strategy for treating T2DM-related non-alcoholic fatty liver disease (NAFLD), and dyslipidemia where it possesses anti-oxidative, anti-inflammatory and anti-dyslipidemic effects.

Outcome of sedentary patients: does the power of zero cac make a difference?

Introduction

Coronary artery calcium score (CACS) and exercise capacity (EC) are both independent prognostic tests in coronary artery disease (CAD).

Purpose

We aimed to assess the incremental prognostic role of EC to CACS, particularly in those with absent or low coronary calcification.

Methods

The cohort consisted of patients who had clinically indicated exercise stress testing and CACS assessment with a median of 27 days of each other. EC was defined based on peak metabolic equivalents (METS) achieved during exercise stress test. CACS was determined using the Agatston method. Patients were followed from the latest test date to incident MACE (inclusive of all-cause death, non-fatal myocardial infarction, late revascularization and admission for heart failure).

Results

There were a total of 1932 patients in the study population (mean age 56±12, 42% female, 48% hypertension, 21% diabetes, 48% dyslipidemia). Peak METS <6 was achieved in 8% of patients, and the median (IQR) CACS was 9 (0–203). Patients with EC <6 METS had doubling of their event rate across strata of CACS, even amongst patients with absent or low coronary calcifications (CACS 0: 4.6 vs 10.9; CACS 1–99: 10.4 vs 20.4; MACE per 1000 person year in patients with peak METS ≥ vs <6 respectively) (Figure 1).

Conclusion

Our findings showed that poor exercise capacity was associated with higher risk even in patients with absent or low coronary calcification.

Funding Acknowledgement

Type of funding sources: None.

A Novel Automated Hematopathologist-Styled Commenter for Complete Blood Count and Smear Review

Introduction/Objective

Prevention of errors and increasing productivity are essential for managing the workflow in hematopathology labs, particularly under stress and fatigue conditions. The proposed automated commenter system is designed to directly address these critical issues. Care was also taken to ensure ease of use and minimum training time.

Methods/Case Report

Using 20 quantitative and qualitative parameters in 3 groups (RBCs, WBCs and platelets), our novel automated commenter is able to generate a hematopathologist’s report/interpretation for CBC and smear review. Built-in reference ranges can be adjusted to accommodate variability in cutoffs. There are alarms for entry of seemingly odd values, differential counts not adding up to 100% or suspected cold agglutination, lipemia and hemolysis in the specimen. Our automated commenter was developed and tested against more than 1,000 hematopathology reports. These reports included clinicopathologic correlations for different type hematopathology neoplasms and benign disorders. At least 100 reports were selected for each disease category covering all subclasses and grades. Ample user acceptance testing was conducted using feedback surveys from hematopathologists, hemato-oncologists and clinicians.

Results (if a Case Study enter NA)

Generated comments are narrative, concise, comprehensive and accurate. The abnormal findings are arranged by their grade and significance. For example, the following comment was generated using the system: “CBC and smear review reveals mild macrocytic pancytopenia with anisocytosis, increased peripheral circulating blasts above the cutoff of Acute Leukemia and critically severe neutropenia (Hgb 11.0 g/dL, MCV 103.5 fL, RDW 14.9%, WBC 3.2 K/µL, blasts 29%, promyelocytes 2%, myelocytes 5%, metamyelocytes 1%, nRBCs 5/100 WBCs, ANC 0.3 K/µL & Plt 125 K/µL) with mild dysgranulopoiesis and dacrocytosis (teardrops).”

Conclusion

Absence of clerical and scientific errors, reportedly positive user experience and saving 50-80% of pathologists’ working time are all advantages that indicate feasibility of large-scale adoption of our system by hematopathology labs. Workflow fitness, standardization, minimizing the manual variations and using the system as a professional training tool also strongly support this conjecture. The system could be used to fully automate clinicopathologic correlation with phenotypic and genetic tests and to develop an automated test selector (Triage Advisor).

Racial disparities of internet access in the united states: a multiyear analysis of the national behavioral risk factors surveillance system

Introduction

The COVID 19 pandemic has led to a dramatic rise in the use of Telehealth. Studies have shown racial/ethnic disparities in internet access, a basic prerequisite for telehealth. However, little is known on the extent of this “digital divide” amongst racial minorities with cardiovascular comorbidities.

Purpose

To investigate racial disparities in internet access amongst those with cardiovascular diseases and risk factors, and explore the degree to which this exists amongst those with different levels of comorbidities.

Methods

Behavioral Risk Factors Surveillance System data from the years 2013–2017, during which survey respondents were asked the main outcome of interest (“Have you used the internet in the past 30 days”) were pooled. Respondents were included if they responded yes to questions on selected cardiovascular diseases and risk factors of interest. Multivariable logistic regression was used to analyze the odds of internet use by racial groups adjusting for several socioeconomic factors.

Results

There were a total of 1,478,214 individuals representing 150,235,244 million adults (non-Hispanic Blacks 11.31% and Hispanics 13.75%). Hispanics and Non-Hispanic Blacks reported the lowest prevalence of internet use (66.1% and 64.4% respectively) compared to Non-Hispanic Whites (81.9%). On regression analysis, racial minorities consistently reported lower rates of internet use, averaging 50% lower odds compared to non-Hispanic Whites. Results remained statistically significant even after controlling for several sociodemographic variables.

Conclusion

Using a large nationally representative cohort, we demonstrated differences in internet access amongst racial minorities and those with multiple comorbidities, placing them at distinct disadvantage with access to telecare. Our study adds to a growing body of literature that shows the disproportionate impact of the pandemic on minorities and calls for a concerted effort to reduce disparities in healthcare delivery.

Funding Acknowledgement

Type of funding sources: None.

Improved Constraints on Primordial Gravitational Waves using Planck, WMAP, and BICEP/Keck Observations through the 2018 Observing Season

We present results from an analysis of all data taken by the BICEP2, Keck Array, and BICEP3 CMB polarization experiments up to and including the 2018 observing season. We add additional Keck Array observations at 220 GHz and BICEP3 observations at 95 GHz to the previous 95/150/220  GHz dataset. The Q/U maps now reach depths of 2.8, 2.8, and 8.8  μK_{CMB} arcmin at 95, 150, and 220 GHz, respectively, over an effective area of ≈600 square degrees at 95 GHz and ≈400 square degrees at 150 and 220 GHz. The 220 GHz maps now achieve a signal-to-noise ratio on polarized dust emission exceeding that of Planck at 353 GHz. We take auto- and cross-spectra between these maps and publicly available WMAP and Planck maps at frequencies from 23 to 353 GHz and evaluate the joint likelihood of the spectra versus a multicomponent model of lensed ΛCDM+r+dust+synchrotron+noise. The foreground model has seven parameters, and no longer requires a prior on the frequency spectral index of the dust emission taken from measurements on other regions of the sky. This model is an adequate description of the data at the current noise levels. The likelihood analysis yields the constraint r_{0.05}<0.036 at 95% confidence. Running maximum likelihood search on simulations we obtain unbiased results and find that σ(r)=0.009. These are the strongest constraints to date on primordial gravitational waves.

A multiparametric MRI-based CAD system for accurate diagnosis of bladder cancer staging

Appropriate treatment of bladder cancer (BC) is widely based on accurate and early BC staging. In this paper, a multiparametric computer-aided diagnostic (MP-CAD) system is developed to differentiate between BC staging, especially T1 and T2 stages, using T2-weighted (T2W) magnetic resonance imaging (MRI) and diffusion-weighted (DW) MRI. Our framework starts with the segmentation of the bladder wall (BW) and localization of the whole BC volume (V_t) and its extent inside the wall (V_w). Our segmentation framework is based on a fully connected convolution neural network (CNN) and utilized an adaptive shape model followed by estimating a set of functional, texture, and morphological features. The functional features are derived from the cumulative distribution function (CDF) of the apparent diffusion coefficient. Texture features are radiomic features estimated from T2W-MRI, and morphological features are used to describe the tumors' geometric. Due to the significant texture difference between the wall and bladder lumen cells, V_t is parcelled into a set of nested equidistance surfaces (i.e., iso-surfaces). Finally, features are estimated for individual iso-surfaces, which are then augmented and used to train and test machine learning (ML) classifier based on neural networks. The system has been evaluated using 42 data sets, and a leave-one-subject-out approach is employed. The overall accuracy, sensitivity, specificity, and area under the receiver operating characteristics (ROC) curve (AUC) are 95.24%, 95.24%, 95.24%, and 0.9864, respectively. The advantage of fusion multiparametric iso-features is highlighted by comparing the diagnostic accuracy of individual MRI modality, which is confirmed by the ROC analysis. Moreover, the accuracy of our pipeline is compared against other statistical ML classifiers (i.e., random forest (RF) and support vector machine (SVM)). Our CAD system is also compared with other techniques (e.g., end-to-end convolution neural networks (i.e., ResNet50).

Socio-demographic and cognitive determinants of xenophobia among the GCC citizens

Introduction

Xenophobia has been referred to as a global phenomenon, linked to the globalization process and noted in countries undergoing transition. It comes from the perceived threat of foreigners’ impact on the citizens’ identity or individual rights. Although the Gulf countries host a large number of migrants from several different cultures and ethnicity, so far no study has examined the conceptualization and pervasiveness of Xenophobia and counter strategies to such phenomenon.

Objectives

Exploring Xenophobia in the Gulf context. Exploring socio-demographic and cognitive factors affecting xenophobia.

Aims

Validating a measure of Xenophobia in the Gulf cultural context. Examining the gender differences in Xenophobia among the GCC individuals. Studying socio-demographic and cognitive predictors of Xenophobia.

Methods

A sample of 513 individuals from the GCC countries completed several measures of socio-demographic and cognitive variables. Likert-type scale of xenophobia was developed and validated on a large sample of Qatari citizens that showed trustworthy indications of validity and reliability and delivered via internet survey.

Results

The findings showed that Xenophobia negatively correlated with age, parents’ level of education, and varied subject to the type of father's job. The females showed Xenophobia more indications than males. Participants from the six GCC countries showed different levels of Xenophobia indicators. Bad experience with expatriates fully mediated the relationship between the socio-demographic of subjects and the number of Xenophobia indicators. Cognitive factors were also good predictors of Xenophobia across all cultures and gender.

Conclusions

Xenophobia in the Gulf region is influenced by several cognitive and socio-demographic factors that is mediated by, but not limited to, negative personal experiences and their cultural backgrounds.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Suppression of the maize phytoglobin ZmPgb1.1 promotes plant tolerance against Clavibacter nebraskensis

Suppression of the maize phytoglobin ZmPgb1.1 enhances tolerance against Clavibacter nebraskensis by promoting hypersensitive response mechanisms mediated by ethylene and reactive oxygen species. Suppression of the maize phytoglobin, ZmPgb1.1, reduced lesion size and disease severity in leaves following inoculation with Clavibacter nebraskensis, the causal agent of Goss's bacterial wilt disease of corn. These effects were associated with an increase of the transcriptional levels of ethylene biosynthetic and responsive genes, which resulted in the accumulation of reactive oxygen species (ROS) and TUNEL-positive nuclei in the proximity of the inoculation site. An in vitro system, in which maize cells were treated with induced xylem sap, was employed to define the cause-effect relationship of these events. Phytoglobins (Pgbs) are hemoglobins able to scavenge nitric oxide (NO). Suppression of ZmPgb1.1 elevated the level of NO in cells exposed to the induced xylem sap causing a rise in the transcript levels of ethylene biosynthesis and response genes, as well as ethylene. Accumulation of ethylene in the same cells was sufficient to elevate the amount of reactive oxygen species (ROS), through the activation of the respiratory burst oxidase homologs (Rboh) genes, and trigger programmed cell death (PCD). The sequence of these events was demonstrated by manipulating the content of NO and ethylene in culture through pharmacological treatments. Collectively, our results illustrated that suppression of ZmPgb1.1 evokes tolerance against C. nebraskensis culminating in the execution of PCD, a key step of the hypersensitive response.

Staged repair of redo and crippled hypospadias: analysis of outcomes and complications

INTRODUCTION

Residual curvature, scarred or absent urethral plate, shortage of skin, and paucity of vascularized tissues and flaps are all obstacles to overcome during repair of redo and cripple hypospadias after failed reconstruction. Limited articles address the outcome of repair of these cases using different grafts.

OBJECTIVE

An analysis of outcomes and complications after the repair of redo and cripple hypospadias in a cohort of children operated by a single surgeon is presented, and data are retrieved from a prospectively designed database.

STUDY DESIGN

Thirty-one children with a median age of 96 months (18-216, interquartile range [IQR]: 78), who underwent previous surgeries three to five times, were operated in the period from late 2011 to August 2017 in a single center by a single surgeon (first author); the first-stage repair was performed by using an inner prepuce graft in three children and oral grafts in 28 children. Penile straightening by degloving and removal of ventral scarred tissues are followed by development of glanular wings and grafting of the ventral surface.

RESULTS

Eleven distal penile hypospadias and 20 posterior hypospadias were operated. First-stage repair was revised in three children; 25 children, eight distal and 17 posterior hypospadias, underwent second-stage repair with a median age of 84 months (18-216, IQR: 60). The success rate after the second-stage repair was 56% (14 children), and complications were encountered in 11 children in the form of penoscrotal fistulae in four, complete dehiscence in one, and glanular dehiscence in six children. After closure of fistulae, the overall success rate increased to 72%. Although complications were more common among children with posterior hypospadias (nine children) than children with distal hypospadias (two children), no statistical significance was reached (p = .234), with no effect of age on complications (p = .233), no effect of the position of the meatus on glanular dehiscence (p = .624), and no effect of age on glanular dehiscence (p = .114).

CONCLUSION

Repair of redo and crippled hypospadias using staged graft repair in children could be achieved with a satisfactory overall success rate of 72%. Glanular dehiscence is the main complication; however, it is not considered by parents of children in the series, necessitating intervention. The lowest complication rate is expected among those with a position of the meatus more distal, however, not proven statistically in the series.

Constraints on Primordial Gravitational Waves Using Planck, WMAP, and New BICEP2/Keck Observations through the 2015 Season

We present results from an analysis of all data taken by the bicep2/Keck CMB polarization experiments up to and including the 2015 observing season. This includes the first Keck Array observations at 220 GHz and additional observations at 95 and 150 GHz. The Q and U maps reach depths of 5.2, 2.9, and 26  μK_{CMB} arcmin at 95, 150, and 220 GHz, respectively, over an effective area of ≈400 square degrees. The 220 GHz maps achieve a signal to noise on polarized dust emission approximately equal to that of Planck at 353 GHz. We take auto and cross spectra between these maps and publicly available WMAP and Planck maps at frequencies from 23 to 353 GHz. We evaluate the joint likelihood of the spectra versus a multicomponent model of lensed-ΛCDM+r+dust+synchrotron+noise. The foreground model has seven parameters, and we impose priors on some of these using external information from Planck and WMAP derived from larger regions of sky. The model is shown to be an adequate description of the data at the current noise levels. The likelihood analysis yields the constraint r_{0.05}<0.07 at 95% confidence, which tightens to r_{0.05}<0.06 in conjunction with Planck temperature measurements and other data. The lensing signal is detected at 8.8σ significance. Running a maximum likelihood search on simulations we obtain unbiased results and find that σ(r)=0.020. These are the strongest constraints to date on primordial gravitational waves.

Serious Renal Disease in Egypt

We studied serious renal disease in Egypt by registering all 155 patients coming to the nephrology service at the University of Cairo during a period of 62 days in 1993. The patients presented with severe uremic symptoms. Admission creatinine and urea levels were high, 804 μmol/l and 64 mmol/l. Fifteen percent of the patients died; 115 underwent dialysis. Sixty patients presented with chronic renal failure; 53 with acute renal failure, but 24 of these were later found to have end-stage renal failure. Of 29 patients with true acute renal failure, 11 (38%) had pre-renal failure and 7 (24%) postrenal failure. Twenty-one patients were followed up after transplantation and chronic dialysis, another 17 had nephrotic syndrome, 3 hypertension, and one had asymptomatic urinary abnormalities. The most common specific etiology for chronic end-stage renal failure was diabetes mellitus type II in the older patients; second most common was Schistosoma in the younger ones. Most diabetic patients came from the city. All but one Schistosoma patient came from rural Egypt. In the 22 patients who underwent renal biopsy the most common diagnosis was mesangio capillary glomerulonephritis. The prevalence of acute renal failure, particularly iatrogenic-toxic, is increasing

Nabiximols combined with motivational enhancement/cognitive behavioral therapy for the treatment of cannabis dependence: A pilot randomized clinical trial

BACKGROUND

The current lack of pharmacological treatments for cannabis use disorder (CUD) warrants novel approaches and further investigation of promising pharmacotherapy. We previously showed that nabiximols (27 mg/ml Δ9-tetrahydrocannabinol (THC)/ 25 mg/ml cannabidiol (CBD), Sativex®) can decrease cannabis withdrawal symptoms. Here, we assessed in a pilot study the tolerability and safety of self-titrated nabiximols vs. placebo among 40 treatment-seeking cannabis-dependent participants.

METHODS

Subjects participated in a double blind randomized clinical trial, with as-needed nabiximols up to 113.4 mg THC/105 mg CBD or placebo daily for 12 weeks, concurrently with Motivational Enhancement Therapy and Cognitive Behavioral Therapy (MET/CBT). Primary outcome measures were tolerability and abstinence, secondary outcome measures were days and amount of cannabis use, withdrawal, and craving scores. Participants received up to CDN$ 855 in compensation for their time.

RESULTS

Medication was well tolerated and no serious adverse events (SAEs) were observed. Rates of adverse events did not differ between treatment arms (F1,39 = 0.205, NS). There was no significant change in abstinence rates at trial end. Participants were not able to differentiate between subjective effects associated with nabiximols or placebo treatments (F1,40 = 0.585, NS). Cannabis use was reduced in the nabiximols (70.5%) and placebo groups (42.6%). Nabiximols reduced cannabis craving but no significant differences between the nabiximols and placebo groups were observed on withdrawal scores.

CONCLUSIONS

Nabiximols in combination with MET/CBT was well tolerated and allowed for reduction of cannabis use. Future clinical trials should explore the potential of high doses of nabiximols for cannabis dependence.

Emotional Expression and Culture: Implications from Nine Arab Countries

Introduction

There is a notion that emotional expression is universal, yet it is subject to cultural variations. Research in this field has studied cultural extremes in European, American and East Asian cultures. However, very little is known about the differences in emotional expression in the Arab subcultures.

Objective

Exploring the differences between the emotional reactions among the nine Arab subcultures.

Aims (1) Examining the cultural differences in emotional reactions; (2) examining the differences between Muslim and non-Muslim individuals; (3) exploring the differences between Arabs and non-Arabs.

Methods

Several real life scenarios including 15 different stressful situations and 15 non-stressful situations were presented to 40 individuals from the nine Arab subcultures. The participants were aged between 18 to 40 years of age. The subjects were randomly classified into groups depending on whether they were Arabs or non-Arabs and according to whether they were Muslims or non-Muslims. The subjects’ emotional reactions were measured by means of Likert-like items.

Results

The results showed that there were no significant differences among the nine Arab subcultures in their emotional reactions to the non-stressful situations. However, there were significant differences among the Arab subcultures in the stressful situations. Moreover, both religion and ethics were strong predictors of the differences in the emotional reactions that varied between subjects in their cultural group. The Arab Muslims tended to express more anger but the Arab non-Muslims expressed more sadness.

Conclusions

Emotional expression is impacted by ones’ cultural background and is particularly influenced by religion and ethics. Although Arab countries share the same language, they express emotions differently.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Serum Fetuin A Levels: Are They a Reliable Marker for Hepatic Steatosis and Regional Adiposity in Renal Transplant Recipients?

BACKGROUND

Fetuin A is a protein expressed in the liver and it is an important inhibitor of ectopic calcification. High levels of fetuin A correlate with insulin resistance, hepatic steatosis, and regional adiposity in the general population. The association between hepatic steatosis and fetuin A level in renal transplant recipients (RTRs) remains unclear.

AIM

The aim of this study was to explore the relationships between fetuin A, hepatic steatosis, and regional adiposity in RTRs.

METHODS

Data from 44 patients with normal renal functions were included, all subjected to history taking for clinical data, assessment of central obesity and regional adiposity, assessment of hepatic steatosis using abdominal ultrasound (US), and measurements of serum fetuin A concentration using enzyme-linked immunosorbent assay (ELISA) kits.

RESULTS

Our study included 20 females (45.4%) and 24 males (54.6%) with mean age of 41.26 ± 11.2 years. Twenty-four subjects had hepatic steatosis. Fetuin A level in RTRs with hepatic steatosis with a mean of 1642.92 ± 358.91 is significantly higher (P < .001) than those without hepatic steatosis with a mean of 711.74 ± 57.85. Serum fetuin A level was positively correlated with regional adiposity (P = .021) and hepatic steatosis grade (P = .017). Fetuin A level increased with increased duration after renal transplantation (P < .001). The best cutoff value for detecting entrance into phase 3 or 4 steatosis is fetuin of 1862 with sensitivity of 88.9% and specificity of 87.7%.

CONCLUSIONS

Fetuin A is positively correlated with hepatic steatosis and regional adiposity in RTRs. Fetuin increases with increased duration after renal transplantation. Accordingly it may be used as a marker for hepatic steatosis and regional adiposity in these patients.

Repair of Experimental Plaque-Induced Periodontal Disease in Dogs

Forty mongrel dogs were used in this study for induction of periodontal disease by placing subgingival silk ligatures affecting maxillary and mandibular premolar teeth during a 12-month period. Experimental premolar teeth received monthly clinical, radiographic, and histometric/pathologic assessments. The results demonstrated significant increases in scores and values of periodontal disease parameters associated with variable degrees of alveolar bone loss. The experimental maxillary premolar teeth exhibited more severe and rapid rates of periodontal disease compared with mandibular premolar teeth. Histometric analysis showed significant reduction in free and attached gingiva of the experimental teeth. Histopathological examination of buccolingual sections from experimental premolar teeth showed the presence of rete pegs within the sulcular epithelium with acanthosis and erosive changes, widening of the periodontal ligament, and alveolar bone resorption. Various methods for periodontal repair were studied in 194 experimental premolar teeth exhibiting different degrees of periodontal disease. The treatment plan comprised non-surgical (teeth scaling, root planing, and oral hygiene) and surgical methods (closed gingival curettage, modified Widman flap, and reconstructive surgery using autogenous bone marrow graft and canine amniotic membrane). The initial non-surgical treatment resulted in a periodontal recovery rate of 37.6 % and was found effective for treatment of early periodontal disease based on resolution of gingivitis and reduction of periodontal probing depths. Surgical treatment by closed gingival curettage to eliminate the diseased pocket lining resulted in a recovery rate of 48.8 % and proved effective in substantially reducing deep periodontal pockets. Open root planing following flap elevation resulted in a recovery rate of 85.4 % and was effective for deep and refractory periodontal pockets. Autogenous bone graft implantation combined with canine amniotic membrane as a biodegradable membrane was used in 18 premolar teeth and failed to improve advanced furcation defects in most teeth.

POSTNATAL GROWTH IN PRETERMS WITH BRONCHOPULMONARY DYSPLASIA

Aim of study - to measure growth data for 69 preterms (39 females) with bronchopulmonary dysplasia (PT-BPD) The growth parameters of 69 BPD-PT were recorded for 16±3 months postnatally. 40 had mild, 20 had moderate and 9 had severe BPD. Ninety-six percent of infants were appropriate for gestational age (AGA). Only 4% preterms had birth weight SDS <-2 for gestational age (GA) and 4% had length SDS (LSDS) <-2. Eighty-eight percent of PT-BPD had normal or accelerated growth velocity (GV) during the 16±3 months period. At 8±2 months of uncorrected age 45% had LSDS <-2 and at 16±3 months of age 25% had LSDS <-2. At 8±2 months 13% had body mass index SDS (BMISDS) < -2 and at 16±3 months 5.8% had BMISDS < -2. At 8±2 months 52% had head circumference SDS (HCSDS2) <-2. At 16±3 months 27.5% had HCSDS <-2. Seventy-two per cent of PT-BPD had normal HCSDS compared to full terms (FT) infants at 16±3 months. The majority of preterm infants with BPD show normal or above normal (catch-up growth) linear growth velocity postnatally compared to FT infants. At 16±3 months of their life 75% had normal LSDS, 72.5% had normal HCSDS compared to FT infants. Severity of the BPD, and the presence of sepsis, NEC, PDA and PVH ominously affects postnatal somatic growth in these infants. Our results stress also the importance of corrected vs uncorrected age for the growth evaluation.