Minimising pain with effective local anaesthesia is an essential step towards improving the level of dentally anxious patients’ comfort during dental treatment. It can be provided by many different techniques. One of them is using the Computer-Controlled Local Anaesthesia Delivery systems (CCLADs). This study was conducted to compare the efficacy of computerised anaesthesia with the conventional technique in terms of perceived pain. A database literature search was performed on PubMed, Cochrane Library and Google Scholar, covering up the period between 2015 and 2023. Only the studies comparing computerised anaesthesia technique with the use of conventional carpule were included. An overview of 20 relevant studies (n = 1347 subjects) was provided including pediatric patients, as well as the adults. The evaluated parameters were: pain, child’s behaviour, heart rate, blood pressure, level of satisfaction, anxiety, further anaesthesia method preference, need for additional anaesthetic, as well as the duration of anaesthesia, measured by different scales, devices and questionnaires. The present literature review led the authors to the conclusion, that the use of CCLADs is significantly less painful than the traditional anaesthesia and it is a promising technique for helping patients deal with pain perception. However, it is advisable to conduct further research on the use of CCLAD.
Background: Alpha-fetoprotein (AFP) and carbohydrate antigen 19-9 (CA 19-9) are two tumor markers that are widely used in the differential diagnosis in patients with primary liver tumors. Very high levels of AFP are sporadically observed in patients with intrahepatic cholangiocarcinoma (ICC) and may cause an incorrect initial diagnosis of hepatocellular carcinoma (HCC). Methods: Two cases of tumors in cirrhotic livers were described, in which the initial diagnosis, based on very high AFP levels (Patient I: 10,464 ng/mL, Patient II: 2212 ng/mL, reference range: ≤8.04 ng/mL) was HCC. In addition, the PubMed database was searched for cases of ICC with elevated AFP. Discussion: In both individuals, liver cirrhosis was diagnosed, but there was no typical rapid “washout” in the contrast-enhanced computed tomography. Based on the histological assessment of samples obtained in the core biopsies, the initially assumed diagnosis of HCC was changed to ICC in both cases. Only nine cases of patients with ICC and high AFP levels were found in the PubMed database. The AFP levels ranged from slightly elevated to over 16,000 ng/mL. Conclusions: A very high AFP level does not necessarily correlate with the presence of HCC. Therefore, the diagnosis has to be verified histologically, when the radiological imaging is uncertain in patients with liver cirrhosis.
Across the world, the incidence of oral squamous cell carcinoma (OSCC) is increasing, establishing it as one of the most prevalent cancers originating in the oral cavity. Estrogen Receptor alpha (ERα) and Estrogen Receptor beta (ERβ) expression were identified and analyzed in normal oral mucosa as well as in squamous cell carcinoma. On a molecular level, estrogens and progestogens, as steroid hormones, influence various biological processes, including reproduction and behavior, by binding to their intracellular receptors. Hypotheses suggest that oral cavity malignancies could be hormonally induced. Periodontal inflammation, mediated by TREM-1, IL-1β, and reduced salivary antibacterial function during hormonal fluctuations, is important in evaluation of etiology of oral cancers and is correlated to hormonal levels. Focal adhesion kinase (FAK) signaling activates ERα through phosphorylation, increasing its transcriptional activity and promoting cell proliferation. Menopausal hormone therapy (MHT) offers both hormonal and non-hormonal treatments, with concerns about overprescription and potential off-label use. In this literature review we aimed to analyze whether there is a link between MHT which consists of estrogen or both estrogen and progesterone and oral cancer risk. A review of the scientific literature covering the years 2018–2025 was carried out, whether estrogens, identified as carcinogens, may be suggested as the potential therapeutic target for OSCC in the future, similar to their well grounded role in the standard management of estrogen receptor-positive breast cancer.