Τετάρτη 22 Νοεμβρίου 2017
Tooth and fail: Four-year wait for dental treatment
Waiting period for public dental treatment in the Northern Territory has blown out from 30.8 months to almost 45.7 months. TERRITORIANS with tooth trouble are waiting almost four years for dental treatment in the public health system, latest figures show.
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Multiple overlapping systematic reviews facilitate the origin of disputes: the case of thrombolytic therapy for pulmonary embolism
Source:Journal of Clinical Epidemiology
Author(s): Nicoletta Riva, Livia Puljak, Lorenzo Moja, Walter Ageno, Holger Schünemann, Nicola Magrini, Alessandro Squizzato
ObjectiveTo explore disagreements in multiple systematic reviews (SRs) assessing the benefit-to-harm ratio of thrombolytic therapy in patients with intermediate-risk pulmonary embolism (PE).Study Design and SettingMEDLINE, EMBASE, CDSR and DARE were searched up to April 14, 2016. We included SRs and guidelines that evaluated thrombolytic therapy, compared to anticoagulation alone, in intermediate-risk PE. We calculated pooled risk ratio (RR) and absolute risk difference (RD), with interquartile range (IQR), for all-cause mortality, recurrent PE and major bleeding.ResultsWe marked PEITHO, the largest trial, as a research milestone. Since its release in 2014, twelve SRs (2-15 included trials) and two major guidelines were published. Studies were concordant in reporting that thrombolysis reduced all-cause mortality (median RD -1.55%, IQR -1.60 to -1.40%; median RR 0.55, IQR 0.48-0.61). Discordant results were found for major bleeding (median RD 4.70%, IQR 0.90-5.70%), with SRs reporting results in opposite directions. Relevant magnitude of effects and precision for benefits and harms were never pre-specified.ConclusionFourteen evidence syntheses were published within 25 months. Conclusions suggested mortality reduction associated with thrombolytics. Therapy harm was more dispersed and alternatively considered. Interpretation of the benefit-to-harm ratio was elusive, and modest incremental advantages might or not be important, facilitating the origin of disputes.
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Response Regarding Surgical Techniques for Retrograde Parotidectomy
Source:American Journal of Otolaryngology
Author(s): Maxwell Kligerman, Uchechukwu Megwalu, Davud Sirjani
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Noise exposure while commuting in Toronto - a study of personal and public transportation in Toronto
Abstract
Background
With an increasing proportion of the population living in cities, mass transportation has been rapidly expanding to facilitate the demand, yet there is a concern that mass transit has the potential to result in excessive exposure to noise, and subsequently noise-induced hearing loss.
Methods
Noise dosimetry was used to measure time-integrated noise levels in a representative sample of the Toronto Mass Transit system (subway, streetcar, and buses) both aboard moving transit vehicles and on boarding platforms from April – August 2016. 210 measurements were conducted with multiple measurements approximating 2 min on platforms, 4 min within a vehicle in motion, and 10 min while in a car, on a bike or on foot. Descriptive statistics for each type of transportation, and measurement location (platform vs. vehicle) was computed, with measurement locations compared using 1-way analysis of variance.
Results
On average, there are 1.69 million riders per day, who are serviced by 69 subway stations, and 154 streetcar or subway routes. Average noise level was greater in the subway and bus than in the streetcar (79.8 +/− 4.0 dBA, 78.1 +/− 4.9 dBA, vs 71.5 +/−1.8 dBA, p < 0.0001). Furthermore, average noise measured on subway platforms were higher than within vehicles (80.9 +/− 3.9 dBA vs 76.8 +/− 2.6 dBA, p < 0.0001). Peak noise exposures on subway, bus and streetcar routes had an average of 109.8 +/− 4.9 dBA and range of 90.4–123.4 dBA, 112.3 +/− 6.0 dBA and 89.4–128.1 dBA, and 108.6 +/− 8.1 dBA and 103.5–125.2 dBA respectively. Peak noise exposures exceeded 115 dBA on 19.9%, 85.0%, and 20.0% of measurements in the subway, bus and streetcar respectively.
Conclusions
Although the mean average noise levels on the Toronto transit system are within the recommended level of safe noise exposure, cumulative intermittent bursts of impulse noise (peak noise exposures) particularly on bus routes have the potential to place individuals at risk for noise induced hearing loss.
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Attempting to validate the overtriage/undertriage matrix at a Level I trauma center
BACKGROUND: The Optimal Resources Document mandates trauma activation based on injury mechanism, physiologic and anatomic criteria and recommends using the overtriage/undertriage matrix (Matrix) to evaluate the appropriateness of trauma team activation. The purpose of this study was to assess the effectiveness of the Matrix method by comparing patients appropriately triaged with those undertriaged. We hypothesized that these two groups are different, and Matrix does not discriminate the needs or outcomes of these different groups of patients. METHODS: Trauma registry data, from January 2013 to December 2015, at a Level I trauma center, were reviewed. Overtriage and undertriage rates were calculated by Matrix. Patients with Injury Severity Score (ISS) of 16 or greater were classified by activation level (full, limited, consultation), and triage category by Matrix. Patients in the limited activation and consultation groups were compared with patients with full activation by demographics, injuries, initial vital signs, procedures, delays to procedure, intensive care unit admission, length of stay, and mortality. RESULTS: Seven thousand thirty-one patients met activation criteria. Compliance with American College of Surgeons tiered activation criteria was 99%. The Matrix overtriage rate was 45% and undertriage was 24%. Of 2,282 patients with an ISS of 16 or greater, 1,026 were appropriately triaged (full activation), and 1,256 were undertriaged. Undertriaged patients had better Glasgow Coma Scale score, blood pressure, and base deficit than patients with full activation. Intensive care unit admission, hospital stays, and mortality were lower in the undertriaged group. The undertriaged group required fewer operative interventions with fewer delays to procedure. CONCLUSION: Despite having an ISS of 16 or greater, patients with limited activations were dissimilar to patients with full activation. Level of activation and triage are not equivalent. The American College of Surgeons Committee on Trauma full and tiered activation criteria are a robust means to have the appropriate personnel present based on the available prehospital information. Evaluation of the process of care, regardless of level of activation, should be used to evaluate trauma center performance. LEVEL OF EVIDENCE: Therapeutic and care management, level III.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2z5yqrk
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Pre-diagnostic dynamic HPV16 IgG seropositivity and risk of oropharyngeal cancer: Methodological issues
We were interested to read the paper authored by Anderson and colleagues that was published in the journal of Oral Oncology in October 2017 [1]. The authors aimed to examine the association of HPV16 antibodies (Abs) and oropharyngeal cancer (OPC) risk in sera obtained prior to clinical diagnosis. They found that Abs to E2 were strongly associated with cases 0–2 years pre- diagnosis (odds ratio (OR): 150.1; 95% confidence interval (CI): 27.4–1040.0) and HPV status (OR: 35.6; 95% CI: 8.7–200.0). Although their study makes valuable contribution to the area, some methodological issues need to be taken into account.
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Small-diameter compression screws completely embedded in bone for rigid internal fixation of the condylar head of the mandible
Complications after open reduction and internal fixation of the condylar head include irritation of the sensitive soft tissues surrounding the temporomandibular joint (TMJ) caused by permanent friction from the screw head,1 and resorption beneath the screw heads because of bony remodelling around the lateral pole.1,2 However, a second operation can risk damage to the facial nerve.
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What to do with medialized tympanostomy tubes? A survey of pediatric otolaryngologists
Tympanostomy tube placement is the most common surgical procedure performed in children. Medial migration of a tympanostomy tube is a rare occurrence where the tube migrates into the middle ear cavity as opposed to its normal extrusion into the external auditory canal. Whether medialized tympanostomy tubes should be surgically removed in asymptomatic patients is controversial. The objective of this study was to determine experience and management approach of medialized tympanostomy tubes among pediatric otolaryngologists.
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Demonstration of analgesic effect of intranasal ketamine and intranasal fentanyl for postoperative pain after pediatric tonsillectomy
Tonsillectomy is one of the oldest and most commonly performed surgical procedure in otolaryngology. Postoperative pain management is still an unsolved problem. In this study, our aim is to demonstrate the efficacy of intranasal ketamine and intranasal fentanyl for postoperative pain relief after tonsillectomy in children.
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Childhood hearing loss is a key feature of CAPOS syndrome: A case report
CAPOS syndrome (cerebellar ataxia, areflexia, pes cavus, optic atrophy, and sensorineural hearing loss) is a rare neurological disorder, recently associated with the c.2452G > A hotspot mutation in the ATP1A3 gene, with sensorineural hearing loss as a prominent feature. We herein report on a girl who has experienced hearing loss for three years following an initial encephalitic episode when aged 15 months old. CAPOS was diagnosed only when she was six years old by targeted testing whilst she displayed optic atrophy, cerebellar signs and areflexia.
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Identification of two novel pathogenic compound heterozygous MYO7A mutations in Usher syndrome by whole exome sequencing
The current study aims to identify the pathogenic sites in a core pedigree of Usher syndrome (USH). A core pedigree of USH was analyzed by whole exome sequencing (WES). Mutations were verified by polymerase chain reaction (PCR) amplification and Sanger sequencing. Two pathogenic variations (c.849+2T>C and c.5994G>A) in MYO7A were successfully identified and individually separated from parents. One variant (c.849+2T>C) was nonsense mutation, causing the protein terminated in advance, and the other one (c.5994G>A) located near the boundary of exon could cause aberrant splicing.
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Spontaneous retropharyngeal and mediastinal thoracic duct cyst in an infant with respiratory distress
Thoracic duct cysts (TDC) within the retropharyngeal space and mediastinum are exceeding rare lesions, with the majority related to trauma or neoplasm. We describe a case of an otherwise healthy 8-month-old boy who presented with severe respiratory distress, which was found to be caused by a large, spontaneous TDC occupying most the retropharyngeal and mediastinal space. To our knowledge, this is the youngest patient to date presenting with TDC. Ultimately, his TDC was completely resolved with sclerotherapy, however the patient's age and size presented unique challenges to his medical management, which we describe below.
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Genetic analysis of CLDN14 in the Chinese population affected with non-syndromic hearing loss
The CLDN14 gene, encoding the tight junction protein Claudin-14, has been proposed as a candidate causative gene affecting autosomal recessive non-syndromic hearing loss (ARNSHL). Genetic analysis of nonsynonymous single-nucleotide variations (nsSNVs) in CLDN14 has been performed in different populations. The role of CLDN14 nsSNVs in contributing to hearing loss in Chinese populations would be investigated in this study.
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Risk factors for QTc interval prolongation
Abstract
Purpose
Prolongation of the QTc interval may result in Torsade de Pointes, a ventricular arrhythmia. Numerous risk factors for QTc interval prolongation have been described, including the use of certain drugs. In clinical practice, there is much debate about the management of the risks involved. In this study, we quantified the effect of these risk factors on the length of the QTc interval.
Methods
We analyzed all ECGs that were taken during routine practice between January 2013 and October 2016 in the Spaarne Gasthuis, a general teaching hospital in the Netherlands. We collected laboratory values in the week before the ECG recording and the drugs prescribed. For the identification of risk factors, we used multilevel linear regression analysis to correct for multiple ECG recordings per patient.
Results
We included 133,359 ECGs in our study, taken in 40,037 patients. Patients using one QT-prolonging drug had a 11.08 ms (95% CI 10.63–11.52; p < 0.001) longer QTc interval. Patients using two QT-prolonging drugs had a 3.04 ms (95% CI 2.06–4.02; p < 0.001) increase in the QTc interval compared to patients using one QT-prolonging drug. Women had a longer QTc interval compared to men (16.30 ms 95% CI 14.59–18.01; p < 0.001). The QTc interval increased with increasing age, but the difference between men and women diminished. Other independent risk factors that significantly prolonged the QTc interval with at least 10 ms were hypokalemia, hypocalcemia, and the use of loop diuretics.
Conclusion
We identified and quantified various risk factors for QTc interval prolongation.
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Cataplexy plus presence of HLA-DQB1*0602 allele can predict Hypocretin-1 deficiency
Currently, narcolepsy patients are treated with stimulants and other drugs for cataplexy.[1] However, emerging therapies focus on hypocretin-1 "replacement" and immunotherapy.[2] Unfortunately, the hypocretin-1 levels in CSF analysis depend on a lumbar puncture and radioimmunoassay, which are not available for the most part in sleep centers. Thus/Therefore, we studied the areas under the ROC curve of clinical or/and electrophysiology methods to predict Hypocretin-1 deficiency.
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Willis-Ekbom disease/restless legs syndrome in patients with opioid withdrawal
Many patients with opioid use disorder report symptoms similar to restless legs syndrome (RLS) during withdrawal. However, whether these symptoms are true RLS, their predictors and effect of treatment with pregabalin are still unknown.
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[Correspondence] Proton-pump inhibitors and glecaprevir plus pibrentasvir in HCV infection
Drug interactions between proton-pump inhibitors and direct-acting antiviral drugs are a great concern in patients with hepatitis C virus infection, because of the potential for suboptimal plasma concentrations of direct-acting antiviral drugs leading to compromised outcomes.1,2 In the phase 3 trial reported by Xavier Forns and colleagues,3 31 (21%) patients with hepatitis C virus infection and compensated cirrhosis receiving glecaprevir plus pibrentasvir were concurrently treated with proton-pump inhibitors.
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[Editorial] Climate change: the role of the infectious disease community
In October, the World Meteorological Organization reported that atmospheric concentrations of CO2 increased at a record rate in 2016 to reach their highest point in 800 000 years. Such statistics are a stark reminder that human beings continue to damage the planet and that not enough is being done to mitigate the harms. Climate change is one of the severest threats to human health and wellbeing. At the end of a year of policy setbacks as well as causes for optimism in addressing climate change, now is a good time to reflect on how the infectious diseases community could respond to the challenge.
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[Correspondence] Proton-pump inhibitors and glecaprevir plus pibrentasvir in HCV infection – Authors' reply
We appreciate Guo Yu and colleagues highlighting the limitations of post-hoc analyses; however, in our study,1 we concluded that the sustained virological response 12 weeks after completion of treatment (SVR12) of 97% (30/31) of patients receiving proton-pump inhibitors suggested an absence of effect on efficacy, rather than concluding that high doses of proton-pump inhibitors (equivalent to 40 mg per day of omeprazole) have no effect on efficacy. Conclusions cannot be reached given the small sample size of the subpopulation of patients receiving proton-pump inhibitors in only one study.
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[Correspondence] Scabies and mortality
Chante Karimkhani and colleagues1 highlighted the substantial burden of scabies, reporting that scabies accounted for 0·21% of disability-adjusted life-years (DALYs) from all conditions globally in 2015. Although the documentation of global morbidity is timely, the contribution of scabies to mortality is yet to be elucidated. Karimkhani and colleagues' DALY calculations were unable to take into account years of life lost (YLL); instead, a null mortality was assumed. Furthermore, scabies was attributed a maximum disability severity of 1, corresponding to itch or pain, which potentially under-represents its severity as a complex disease process.
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[Clinical Picture] A travelling camper with a spiking fever, headache, myalgia, hepatitis, and intracellular inclusions
A previously healthy 60-year-old Norwegian man presented to the emergency department of Stavanger University Hospital in late May 2016 with a 10-day history of spiking fever, headache, and myalgia. The patient was in good general condition, with normal vital signs, but he developed fever spikes within a few hours of admission. Physical examination was unremarkable.
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[Correspondence] Can defective interfering RNAs affect the live attenuated influenza vaccine?
In their thoughtful Personal View, Anika Singanayagam and colleagues1 raise several important questions relating to the apparent loss of efficacy of the live attenuated influenza virus (LAIV) vaccine. One factor not considered by the authors is the presence, in batches of the Fluenz Tetra vaccine (MedImmune, Nijmegen, Netherlands; AstraZeneca, Luton, UK) of substantial amounts of small RNAs derived from the genomes of both the influenza A and influenza B components of the vaccine itself.2 If the vaccine was composed only of infectious virus, one would expect to see only the eight full-length influenza segments of the viral A and B genomes.
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[Clinical Picture] Tuberculosis of the tonsil simulating a cancer
A 36-year-old woman presented with a 1-month history of sore throat and progressive dysphagia. She had no history of any serious illness, chronic cough, or other chest symptoms. She had been taking various courses of antibiotics, including amoxicillin and a combination of amoxicillin plus clavulanic acid, and paracetamol for sore throat without any relief.
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[Correspondence] Can defective interfering RNAs affect the live attenuated influenza vaccine? – Authors' reply
We thank Nigel Dimmock and Andrew Easton for drawing attention to new research, which has become available since the publication of our article,1 describing their interesting observation of defective interfering RNAs in two batches of Fluenz Tetra (MedImmune, Nijmegen, Netherlands; AstraZeneca, Luton, UK) for the 2014–15 influenza season.2 This research warrants further investigation to understand its implications.
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[Correspondence] Diagnostic algorithm for low-volume CSF samples in tuberculous meningitis
Nathan Bahr and colleagues1 reported the diagnostic accuracy of Xpert MTB/RIF Ultra for tuberculous meningitis in HIV-infected adults. They report significantly high sensitivity of Xpert-Ultra (95%) versus Xpert (45%), which was similar to Mycobacteria Growth Indicator Tube (MGIT) culture. The authors also show that no test is 100% accurate, and even Xpert-Ultra can miss or give indeterminate results in culture-positive cases.
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[Media Watch] Anti-vaxxers are antisocial
Over the years, academics have used all sorts of techniques during their shows at the Cabaret of Dangerous Ideas (CODI)—from music and props to experiments involving audience members. Yet, Dr Clare Taylor, Senior Lecturer in Medical Microbiology at Edinburgh Napier University, UK, is the first scientist I have seen who has started her show by tweeting. Taylor took to Twitter at the beginning of "Anti-vaxxers are antisocial" on Aug 12, 2017, to ask the US President, Donald Trump, "@realDonaldTrump a quick question, have your kids been vaccinated? @CODIfringe".
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[Correspondence] Prediction and prevention of tuberculosis in contacts
Targeting of treatment of latent tuberculosis infection to patients at highest risk is a key component of the prevention and control of the disease, and any measure to reach that target with less effort is valuable. Matthew Saunders and colleagues1 derived a composite risk score to predict and stratify the risk of active tuberculosis in adult contacts of index cases with pulmonary tuberculosis from an underprivileged Peruvian community. In an independent prospective validation cohort, the score retained its predictive value.
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[Newsdesk] Research brief
Squirrels might have caused or maintained an epidemic of leprosy in medieval England. Genetic analysis of Mycobacterium leprae from a pre-Norman skull found in a garden in Suffolk has lent support to the suggestion that East Anglia was the epicentre of the medieval leprosy epidemic. The M leprae strain found on the skull matches the strain found on skeletal remains from medieval Denmark and Sweden. The bacteria might have arrived on the east coast of England along viking trade routes for the then-popular squirrel meat and fur.
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[Correspondence] Prediction and prevention of tuberculosis in contacts – Authors' reply
We thank Sandra Arend and Jonathan Uzorka for their interest in our study. They argue that because our risk score predicts tuberculosis independently of the contact tuberculin skin test (TST) results and index case smear grade, it is likely that subsequent re-exposure to tuberculosis was an important risk factor. Therefore, they debate the justification for our calculation of numbers needed to treat (NNT) with preventive therapy at the time of known exposure to prevent each tuberculosis case. Although we agree that re-exposure might have been an important, unmeasured risk factor in our population, the highest rate of tuberculosis among contacts was in the first year after known exposure, and nearly all the cases occurred during the first 3 years.
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[Newsdesk] Infectious disease surveillance update
Since the outbreak began in August, 2017, the total number of cases of plague in Madagascar has risen to 1554, including 113 deaths as of Oct 27. 63% of patients have the pneumonic form of the illness, which spreads from person to person. 40 of the 114 districts in Madagascar have reported pneumonic plague cases during this outbreak, including the most populous cities of Antananarivo and Toamasina. Contact tracing is ongoing; so far 30% of people who have had contact with cases have been traced.
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[Correspondence] Emergence of Plasmodium falciparum triple mutant in Cambodia
We share Mallika Imwong and colleagues'1 concern regarding the spread of single-fit multidrug-resistant Plasmodium falciparum malaria parasites along the borders of Cambodia—ie, to Thailand, Laos, and Vietnam. In 2016, in Cambodia, artesunate-mefloquine (ASMQ) replaced dihydroartemisinin-piperaquine (DHA-PPQ) as the first-line treatment for uncomplicated P falciparum malaria. The rationale for this combination relies on evidence that parasites carrying markers of resistance both to artemisinin (pfKelch13-580Y mutant) and piperaquine (later associated with the amplification of pfplasmepsin2)3,4 have regained susceptibility to mefloquine (low in vitro IC50 [half maximal inhibitory concentration] values and the single-copy pfmdr1, the amplification of which has been associated with mefloquine resistance).
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[Newsdesk] Highlights from IDWeek 2017
IDWeek brings together experts across infectious diseases and health-care epidemiology. This year's meeting was held in San Diego, Oct 4–8. Sean Cleghorn describes the highlights.
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[Newsdesk] Plague in Madagascar
Madagascar has long been affected by plague, but the latest outbreak is proving unusual in more ways than one. Talha Burki reports.
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[Newsdesk] Marseilles' lazaretto for the 21st century
A new integrated infectious diseases facility opened in Marseilles last year. John McConnell paid a visit.
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[Correspondence] Prediction and prevention of tuberculosis in contacts
We read with great interest the Article by Matthew Saunders and colleagues on the use of a tuberculosis risk score.1 The authors developed their much-needed scoring system to predict the risk of tuberculosis development in contacts of patients with pulmonary tuberculosis. They also showed the feasibility of their scoring system in a population of contacts of patients with tuberculosis. However, their score slightly overestimated the risk in the high-risk group of the external validation cohort (the observed 2·5-year risk was 11·6% in the high-risk group in the derivation cohort vs 8·6% in the external validation cohort).
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[Comment] Addressing antimicrobial resistance in the UK and Europe
Antimicrobial resistance (AMR) has received substantial attention in recent years. Since bacteria evolve to resist the effects of existing antibiotics, infections can become more difficult to treat and subsequently modern medical interventions can become more dangerous for patients. Fear of so-called superbugs has spurred international authorities into action. In 2011, WHO developed a European strategic action plan on antibiotic resistance,1 which set forth strategic objectives to aid European member states in addressing the complex factors that cause AMR.
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Covariate balance for no confounding in the sufficient-cause model
To show conditions of covariate balance for no confounding in the sufficient-cause model and discuss its relationship with exchangeability conditions.
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Mediating Effects of Cancer Risk Factors on the Association between Race and Cancer Incidence; Analysis of the NIH-AARP Diet and Health Study
Racial disparities exist in both the prevalence of cancer-related risk factors and incidence of cancer. The objective of this study is to determine if cancer-related risk factors mediate the association between race and cancer incidence.
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County-level contextual factors associated with diabetes incidence in the United States
Health and administrative systems are facing spatial clustering in chronic diseases such as diabetes. This study explores how geographic distribution of diabetes in the U.S. is associated with socioeconomic and built environment characteristics and health-relevant policies.
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New Alberta dental fee guide aimed at drilling cost of several procedures
A new dental fee guide has been announced in Alberta that the government says will help patients get greater value from the money they pay their dentists. The guide - the first in more than two decades - suggests an 8.5 per cent reduction in prices for 60 common dental procedures.
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Trends in cardiovascular risk factors among U.S. men and women with and without diabetes, 1988–2014
Studies evidenced that reduction in cardiovascular disease (CVD) mortality in diabetic patients can be attributed to improvements in major CVD risk factors and evidence-based treatments. Furthermore, studies s...
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How do public health professionals view and engage with research? A qualitative interview study and stakeholder workshop engaging public health professionals and researchers
With increasing financial pressures on public health in England, the need for evidence of high relevance to policy is now stronger than ever. However, the ways in which public health professionals (PHPs) and r...
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Nutritional assessment of critically ill patients: validation of the modified NUTRIC score
Nutritional assessment of critically ill patients: validation of the modified NUTRIC score
Nutritional assessment of critically ill patients: validation of the modified NUTRIC score, Published online: 23 November 2017; doi:10.1038/s41430-017-0008-7
Nutritional assessment of critically ill patients: validation of the modified NUTRIC score
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Association of maternal breast milk and serum levels of macronutrients, hormones, and maternal body composition with infant’s body weight
Association of maternal breast milk and serum levels of macronutrients, hormones, and maternal body composition with infant's body weight
Association of maternal breast milk and serum levels of macronutrients, hormones, and maternal body composition with infant's body weight, Published online: 23 November 2017; doi:10.1038/s41430-017-0022-9
Association of maternal breast milk and serum levels of macronutrients, hormones, and maternal body composition with infant's body weight
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The effect of weight change over a 2-year period on inflammatory status in postmenopausal women
The effect of weight change over a 2-year period on inflammatory status in postmenopausal women
The effect of weight change over a 2-year period on inflammatory status in postmenopausal women, Published online: 23 November 2017; doi:10.1038/s41430-017-0014-9
The effect of weight change over a 2-year period on inflammatory status in postmenopausal women
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The effect of supragingival biofilm re-development on the subgingival microbiota in chronic periodontitis
Source:Archives of Oral Biology, Volume 85
Author(s): Fátima Aparecida Rocha Resende Hartenbach, Carina Maciel Silva-Boghossian, Ana Paula Vieira Colombo
ObjectiveIn this study, we hypothesized that in the absence of oral hygiene, re-growth of the climax microbial communities of supra and subgingival biofilm happens in a faster and more intense fashion in individuals with chronic periodontitis (CP) compared to periodontally healthy controls (PH).DesignThirty patients (PH=15 and CP=15) received professional supragingival prophylaxis, and were asked to refrain from oral hygiene for 7days. Supra and subgingival biofilm samples and GCF were collected from randomly selected quadrants at baseline (before prophylaxis), immediately after prophylaxis, 2h, 6h, 24h, and 7days after prophylaxis. The composition of the biofilm was determined by the checkerboard method.ResultsAll subjects developed gingivitis at the end of 7days without oral hygiene. GCF mean volumes were significantly higher in CP than PH patients at baseline, but they started decreasing 2h after prophylaxis, returning to baseline levels after 24h in both groups. Significant increases in mean counts for most of the species evaluated were observed in both groups and biofilms over time (p<0.05). Few hours after prophylaxis, a more marked reduction in microbial counts happened in the supragingival biofilm of the CP group, and re-development of biofilm started later than in the PH group. At 7days, no differences were seen between groups. Significant differences in kinetics of re-colonization between groups were observed only in the subgingival biofilm for T. denticola and F. nucleatum ss vicentii (increased in the CP), and N. mucosa (increased in the PH group; p<0.05).ConclusionsBiofilm re-development was very similar between CP and PH individuals, although microbial re-growth occurred few hours earlier in PH than PC. Only 3 species in the subgingival biofilm differed in re-colonization between groups. Thus, we reject the hypothesis that re-colonization of biofilm in CP patients is more intense and faster than in individuals with PH.
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Aims & Scope/Editorial board
Source:Archives of Oral Biology, Volume 85
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Homeobox genes and tooth development: Understanding the biological pathways and applications in regenerative dental science
Source:Archives of Oral Biology, Volume 85
Author(s): Anand Ramanathan, Thekkeparambil Chandrabose Srijaya, Prema Sukumaran, Rosnah Binti Zain, Noor Hayaty Abu Kasim
ObjectivesHomeobox genes are a group of conserved class of transcription factors that function as key regulators during the embryonic developmental processes. They act as master regulator for developmental genes, which involves coordinated actions of various auto and cross-regulatory mechanisms. In this review, we summarize the expression pattern of homeobox genes in relation to the tooth development and various signaling pathways or molecules contributing to the specific actions of these genes in the regulation of odontogenesis.Materials and methodsAn electronic search was undertaken using combination of keywords e.g. Homeobox genes, tooth development, dental diseases, stem cells, induced pluripotent stem cells, gene control region was used as search terms in PubMed and Web of Science and relevant full text articles and abstract were retrieved that were written in English. A manual hand search in text books were also carried out. Articles related to homeobox genes in dentistry and tissue engineering and regenerative medicine of odontogenesis were selected.ResultsThe possible perspective of stem cells technology in odontogenesis and subsequent analysis of gene correction pertaining to dental disorders through the possibility of induced pluripotent stem cells technology is also inferred.ConclusionsWe demonstrate the promising role of tissue engineering and regenerative medicine on odontogenesis, which can generate a new ray of hope in the field of dental science.
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Novel methodology for determining the effect of adsorbates on human enamel acid dissolution
Source:Archives of Oral Biology, Volume 85
Author(s): N. Pechlivani, D.A. Devine, P.D. Marsh, A. Mighell, S.J. Brookes
ObjectiveThe effect of various interventions on enamel demineralisation can be determined by chemically measuring mineral ions dissolved by the attacking acid. Results are usually expressed as mineral loss per surface area of enamel exposed. Acid resistant varnish or adhesive tape are typically used to delineate an area of enamel. However, enamel surface curvature, rugosity and porosity reduce the reliability of simple area measurements made at the macro scale. Our aim was to develop a simple method for investigating the effect of adsorbates on enamel demineralisation that does not rely on knowing the area of enamel exposed. As an exemplar we have used salivary proteins as a model adsorbate.DesignNatural human tooth enamel surfaces were subjected to five sequential acid challenges and then incubated in adsorbate (whole clarified saliva) followed by a further 15 acid challenges. Demineralisation was determined by measuring the phosphate released into the acid during each exposure by a spectrophotometric assay. The initial five challenges established a mean baseline mineral loss for each tooth against which the effect of subsequently adsorbed proteins could be compared.ResultsSalivary proteins significantly reduced the acid demineralisation of human enamel by 43% (p<0.01). Loss of proteins during each challenge corresponded to a gradual reduction in the degree of protection afforded.ConclusionsThe methodology provides a simple and flexible means to investigate the effect of any adsorbate on enamel acid dissolution. Knowledge of the area of exposed enamel is irrelevant as each tooth acts as its own negative control.
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Raloxifene reduces the risk of local alveolar bone destruction in a mouse model of periodontitis combined with systemic postmenopausal osteoporosis
Source:Archives of Oral Biology, Volume 85
Author(s): Ryota Ichimaru, Tsukasa Tominari, Shosei Yoshinouchi, Chiho Matsumoto, Kenta Watanabe, Michiko Hirata, Yukihiro Numabe, Gillian Murphy, Hideaki Nagase, Chisato Miyaura, Masaki Inada
OBJECTIVEPeriodontitis is characterized by local inflammation leading to tooth loss and severe destruction of alveolar bone. Raloxifene is a selective estrogen receptor modulator (SERM) that halts estrogen deficiency-induced systemic bone loss in postmenopausal osteoporosis without the side effects of cancer in breast and uterus. In this study, we examined the effects of raloxifene on alveolar bone mass in a mouse model with estrogen deficiency-induced periodontitis.METHODSPeriodontitis was induced by the injection of lipopolysaccharide (LPS) into the lower gingiva in ovariectomized (OVX) mice, and the alveolar bone and femur bone mineral density (BMD) were analyzed by dual-energy X-ray absorptiometry. To explore the direct osteoclast inhibitory effect of raloxifene, a co-culture system for osteoclast formation and organ culture of alveolar bone was established.RESULTSWhen OVX mice were treated with raloxifene, the bone loss in both alveolar bone and femur were abrogated. Interleukin 1 and/or LPS stimulated the osteoclast formation and bone-resorbing activity; however, raloxifene did not show any inhibitory effect on the osteoclast formation or function. In vivo local injection of raloxifene also did not prevent bone resorption in a mouse model of periodontitis. However, the systemic treatment of raloxifene using a mini-osmotic pump did prevent the loss of BMD of alveolar bone induced by LPS.CONCLUSIONThese results suggest that the SERM raloxifene systemically maintain alveolar bone mass in a mouse model of periodontitis with osteoporosis. Increasing the alveolar bone mass by SERMs treatment in patients with postmenopausal osteoporosis may be a useful approach to preventing the destruction of alveolar bone in late-onset periodontitis.
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Cdc42 is essential for the polarized movement and adhesion of human dental pulp stem cells
Source:Archives of Oral Biology, Volume 85
Author(s): Mingwei Li, Liang Ma, Bing Song, Dingyi Yu, Min Xiao, Xiaohan Mei, Huihui Guo, Qing Yu
ObjectiveStem cell-based tissue repair and regeneration require the regulation of cell migration and adhesion. As a regulator of cell polarization, Cdc42 (cell division control protein 42) plays a basic role at the initial stage of cell migration and adhesion. This study explores the effect of Cdc42 on the polarized migration and adhesion of hDPSCs (human dental pulp stem cells).DesignHDPSCs were isolated from extracted third molars and transfected with siRNA targeted against Cdc42. Scratch wound assays and transwell assays were performed to detect the migration of human dental pulp stem cells. Polarization assays were applied to explore the polarized movement of Golgi bodies and nuclei.Western blot was used to examine the expression of related proteins.ResultsThe expression of Cdc42 was knocked down by siRNA transfection, which inhibited the migration of hDPSCs in both the scratch wound assays and transwell assays. Meanwhile, the proportion of polarized hDPSCs during migration was also decreased, and the adhesion ability of hDPSCs was downregulated. Western blot demonstrated that these effects were dependent on FAK (focal adhesion kinase), β-catenin and GSK3β (Glycogen synthase kinase-3β).ConclusionOur study demonstrates that Cdc42 plays an essential role during the polarized movement and adhesion of hDPSCs.
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Inhibitory effect of probiotic lactobacilli supernatants on single and mixed non-albicans Candida species biofilm
Source:Archives of Oral Biology, Volume 85
Author(s): Yulong Tan, Matthias Leonhard, Doris Moser, Su Ma, Berit Schneider-Stickler
ObjectivesOral candidiasis is one of the most common human fungal infections. While most cases of the Candida species isolated from the oral cavity are Candida albicans, a large number of candidiasis is attributed to non-albicans Candida species. In this study, we aim to evaluate the in vitro inhibition of supernatants of Lactobacillus gasseri and Lactobacillus rhamnosus on the single and mixed species biofilm of non-albicans Candida species, including Candida tropicalis, Candida krusei and Candida parapsilosis.DesignCell-free supernatants of Lactobacillus gasseri and Lactobacillus rhamnosus were prepared. Single and mixed non-albicans Candida species biofilm were formed in the 96-well microplate and on the surfaces of medical grade silicone. Biomass and cell viability were tested with crystal violet and cell counting kit-8. In order to examine the ability of the supernatant to disrupt pre-formed biofilm, supernatant was added to 24h-old biofilms. Biofilm architecture on silicone was investigated by scanning electron microscopy and confocal laser scanning microscopy was used to examine live/dead organisms within biofilm.ResultsSingle and mixed species biofilms and cell viability of non-albicans Candida biofilms were inhibited by probiotic lactobacilli supernatants. Matrue biofilm formation was disrupted by lactobacilli supernatants added at 24h after biofilm initiation. Examination with confocal laser scanning microscopy and scanning electron microscopy confirmed that lactobacilli supernatants inhibited the mixed biofilms and damaged the cells.ConclusionsOur data elucidate the inhibitory activity of probiotic lactobacilli on non-albicans Candida biofilm, so as to support their utility as an adjunctive therapeutic mode against oral candida infections.
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Colonization of oropharynx and lower respiratory tract in critical patients: Risk of ventilator-associated pneumonia
Source:Archives of Oral Biology, Volume 85
Author(s): Ivany Machado de Carvalho Baptista, Frederico Canato Martinho, Gustavo Giacomelli Nascimento, Carlos Eduardo da Rocha Santos, Renata Falchete do Prado, Marcia Carneiro Valera
ObjectiveTo investigate the microbial diversity existing in oral cavity and respiratory tract samples (from mini-bronchoalveolar lavage (BAL), endotracheal aspirate, and orotracheal tube) of patients on mechanical ventilation by using the checkerboard DNA-DNA hybridisation. Also, the study aimed to evaluate whether the microbial profile in the oral cavity is found in respiratory tract samples, at different periods of mechanical ventilation time (12h, 48h, 96h) in attempt to identification of relationship between VAP (ventilator-associated pneumonia) and bacterial species studied. The last objective was to analyses correlation between blood cultures and VAP.DesignThe samples were collected from ten patients in intensive care unit with medical prescription of orotracheal intubation and mechanical ventilation. Clinical data were tabulated and blood cultures were performed according medical indication. For checkerboard samples collection, chosen sites were the dorsal side of the tongue and gingival sulcus at 12h, 48h, 96h, BAL, at 12h, endotracheal aspirate at 48 and 96h, and orotracheal tube at extubation time, when feasible.ResultsIt was possible to identify the presence of bacterial species in mouth and in the BAL/endotracheal aspirate. The data demonstrated an increase in the quantity of bacterial associated with prolonged use of mechanical ventilation (48 and 96h).ConclusionsBacterial species may migrate rapidly from mouth and upper airways during orotracheal intubation which contributes to the pathogenesis of VAP. There were associations between VAP and Enterococcus faecalis, Fusobacterium periodonticum, Gemella morbillorum, Neisseria mucosa, Propionibacterium acnes, Prevotella melaninogenica, Streptococcus oralis, Streptococcus sanguinis, Treponema denticola, Treponema socransckii, and Veillonella parvula.
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Probiotic intervention influences the salivary levels of Matrix Metalloproteinase (MMP)-9 and Tissue Inhibitor of metalloproteinases (TIMP)-1 in healthy adults
Source:Archives of Oral Biology, Volume 85
Author(s): Heli Jäsberg, Taina Tervahartiala, Timo Sorsa, Eva Söderling, Anna Haukioja
ObjectiveTo study the effect of orally administered Bifidobacterium animalis subsp. lactis BB-12 and Lactobacillus rhamnosus GG on the salivary levels of Matrix Metalloproteinases (MMP)-8, MMP-9 and of Tissue Inhibitor of Metalloproteinases (TIMP)-1 in healthy adults. Furthermore, the correlations between MMP-8, MMP-9 and TIMP-1 and plaque and gingival indices, salivary mutans streptococci and lactobacilli counts, and stimulated saliva secretion rate were analysed.DesignThe salivary samples originated from a randomized controlled trial where healthy student volunteers consumed probiotic or placebo lozenges twice a day for four weeks. The saliva samples were collected and clinical parameters measured at the baseline and at the end of the original study. For this study, the salivary levels of MMP-8, MMP-9 and TIMP-1 were analysed with immunofluorometric assay (IFMA) and enzyme-linked immunosorbent assay (ELISA).ResultsIn the probiotic group (n=29), salivary MMP-9 levels increased (p<0.01) and TIMP-1 levels decreased (p<0.01) significantly during the intervention. Furthermore, MMP-9/TIMP-1 ratio differed significantly from the baseline level (p<0.01). These changes were not observed in the control group (n=31). In the whole data, salivary MMP-9 and gingival index correlated (r=0.260, p<0.05 at baseline and r=0.354, p<0.01 at the end of the study). Intergroup differences or correlations with other clinical parameters were not found. Probiotic consumption did not affect the saliva flow rate.ConclusionsIncreased MMP-9 and decreased TIMP-1 levels in saliva may indicate that probiotics have immunomodulatory effects in the oral cavity. Furthermore, increased salivary MMP-9 levels may be an indication of the defensive potential of matrix metalloproteinases.
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Reactivation of peroxidase activity in human saliva samples by polyphenols
Source:Archives of Oral Biology, Volume 85
Author(s): Jana Gau, Jürgen Arnhold, Jörg Flemmig
ObjectivesThe enzyme lactoperoxidase (LPO), which is released into several body fluids like saliva, is an essential part to maintain the oral bacterial homeostasis by catalysing the oxidation of thiocyanate (SCN−) to hypo-thiocyanite (−OSCN). The formation of unreactive redox intermediates (like Compound II) leads to a decreased pseudo-halogenating enzyme activity, which is associated with a higher risk for oral infections. According to former studies with bovine LPO selected flavonoids were tested in respect to their potential to reactivate the enzymatic activity in a more physiological, human salivary system.DesignSaliva samples from healthy donors were collected and characterized by using several gel staining methods and immunoblotting. Afterwards kinetic measurements were performed by applying the TNB-assay to evaluate the pseudo-halogenating salivary peroxidase (SAPX) activity. The measurements were performed in the presence of excess H2O2 to simulate pro-inflammatory conditions. Moreover selected flavonoids or an ethanolic extract of Tormentillae rhizoma were applied to test their regenerating effect on the LPO-derived −OSCN production.ResultsDespite the complex protein composition of the collected saliva samples, an SAPX-derived pseudo-halogenating activity could be identified. The −OSCN regenerating effects of the tested polyphenols were completely comparable to previous in vitro experiments with bovine LPO. Thus, we could show that phenolic substances are suitable to regenerate the peroxidase activity in human saliva samples after H2O2-induced inactivation.ConclusionThe studies provide new insights into the effect of pharmaceutical relevant polyphenols on salivary peroxidase activity and thus, suggest this enzyme as a new target for the prevention and therapy of oral inflammatory diseases.
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Little Rock dentist sues over his arrest
KARK/Fox 16 reports that Dr. Jose Turcios, a Little Rock dentist acquitted of a charge that he'd molested a teen patient, has sued police officers who participated in his investigation and arrest. Turcios, represented by Mike Laux, says one investigator was married to a dentist, giving him a conflict of interest, and two other investigators who were in a relationship and later married fabricated evidence so they could spend more time together.
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Church distributes 59 new pairs of glasses recently
Volunteers at a local church recently handed out 59 pairs of glasses to people in the community virtually free of cost. In October, the Seventh-day Adventist Church held a health expo that offered dental care, eye exams and health screenings to all attendees.
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A giving soul
"We make a living by what we get. We make a life by what we give," Winston S. Churchill said.
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The Apple Watch can accurately detect hypertension and sleep apnea, a new study suggests
A new study out from health startup Cardiogram and the University of California San Francisco (UCSF) suggests wearables like the Apple Watch, Fitbit and others are able to accurately detect common but serious conditions like hypertension and sleep apnea.
Cardiogram and USCF previously demonstrated the ability for the Apple Watch to detect abnormal heart rhythm with a 97 percent accuracy. This new study shows the Watch can detect sleep apnea with a 90 percent accuracy and hypertension with an 82 percent accuracy.
Read more at: Tech Crunch
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Mouth rinsing with a carbohydrate solution attenuates exercise-induced decline in executive function
A decline in executive function could have a negative influence on the control of actions in dynamic situations, such as sports activities. Mouth rinsing with a carbohydrate solution could serve as an effectiv...
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Food Co. Issues Allergy Alert on Undeclared Allergen (E.G. Milk) in Product
Colorado Nut Company of Denver, CO is recalling Cashew Cranberry Cherry Jubilee, Oat Bran Nutty Crunch, Honey Nutty Granola, Peanut Delight, and Frontier Trail Mix, because they may contain undeclared Milk. People who have an allergy or severe sensitivity to Milk run the risk of serious or life-threatening allergic reaction if they consume these products.
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American Academy of Periodontology and European Federation of Periodontology Host World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions
More than 100 periodontal thought leaders convene to establish up-to-date diagnosis guidelines
In conjunction with the European Federation of Periodontology (EFP), the American Academy of Periodontology (AAP) hosted the World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions Nov. 9 -11 at the Gleacher Center in Chicago. More than 100 international researchers, educators, and clinicians gathered to review the latest literature and come to consensus on up-to-date guidelines for periodontal and peri-implant disease diagnosis and definition.
Participants conducted literature reviews, established case definitions, and deliberated diagnostic considerations for the following topic areas: periodontal health and gingival diseases and conditions; periodontitis; developmental and acquired conditions and periodontal manifestations of systemic conditions; and peri-implant diseases and conditions. The inclusion of peri-implant diseases and conditions within periodontal disease classifications is a first, accommodating for what scientists and practitioners have come to understand about implant dentistry.
"Since the last World Workshop was held in 1999, periodontics has made notable advancements in the treatment and diagnosis of periodontal disease. The 2017 workshop intended to account for what we've learned in the last 18 years and help standardize the specialty's definition of disease," says Dr. Steven R. Daniel, president of the AAP. "Our collaboration with the EFP and periodontists from all over the world will work to positively shape the quality of patient care globally."
The 2017 World Workshop is the second recent collaboration of the EFP and AAP. The groups' joint workshop on periodontitis and systemic disease in 2012 was a major milestone in the specialty's understanding of the perio-systemic link.
"After three years of preparation, it was rewarding to see many of the best and brightest in periodontics convene to accomplish the important task of updating and standardizing the definitions of periodontal and peri-implant diseases that will be used by dental professionals around the world. The contributions of the Workshop's expert participants will set the stage for periodontics' expansive future," says Dr. Jack Caton, co-chair of the event's organizing committee.
Proceedings from the 2017 World Workshop on Periodontal Disease Classification will be published in both the AAP's Journal of Periodontology and the EFP's Journal of Clinical Periodontology in 2018. The Workshop was presented with support from the AAP Foundation, Colgate, Johnson and Johnson, Geistlich Biomaterials, SUNSTAR, and Procter and Gamble.
About the American Academy of Periodontology
The American Academy of Periodontology (AAP) represents over 8,000 periodontists—specialists in the prevention, diagnosis, and treatment of inflammatory diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontics is one of the nine dental specialties recognized by the American Dental Association.
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To fluoridate or not to fluoridate?
Debra Gaines, left, and David Burke hold signs protesting the addition of fluoride to Edgartown water before a special town meeting last week. The issue was back before the board of health Tuesday evening who noted that petitioners have gathered enough signatures to put it before voters.
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Hours worked and patient visits provided by dentists in Australia
Abstract
Objectives
To examine numbers of hours worked and patient visits provided by age and sex of dentist in Australia, and compare with previous estimates to describe trends.
Methods
Data were collected by mailed survey from a random sample (n=2,961) of Australian dentists. Private sector dentists working in clinical practise were included in the analysis. Data were weighted to the age and sex distribution of Australian practising dentists.
Results
The adjusted response rate was 49% (n=1,345 dentists). Hours per year worked and number of patient visits per year were lower for dentists aged 65+ years than younger dentists, and were higher for male compared with female dentists aged 35-45 to 55-64 years. Hours per year worked were lower in 2013-14 than reported in 2009-10, but the number of patient visits in 2013-14 was similar to the previously reported estimate from 2009-10.
Conclusions
Hours worked and visits provided were only lower among older dentists aged 65 years or more. Male dentists tend to work more hours per year and provide more patient visits per year than female dentists. Over the last decade, Australian dentists maintained a stable output of visits per year despite a trend towards fewer hours worked per year.
This article is protected by copyright. All rights reserved.
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Worsening Respiratory Distress in a 7-Month-Old Infant
A 7-month-old male presented with noisy breathing; he fed poorly from the bottle with frequent choking, grunting, and irritability; nasopharyngolaryngoscopy showed no laryngomalacia, laryngeal lesions, or cord paralysis. What is your diagnosis?
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Hearing Difficulty in the United States
This survey study analyzes the epidemiologic features and treatment patterns of hearing difficulty in the United States using data from responses from the 2014 National Health Interview Survey.
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Association of Neurocognitive Decline Treated With Radiotherapy or Chemoradiotherapy for Head and Neck Cancer
This prospective, longitudinal study assesses objective neurocognitive function before and after definitive radiation therapy for patients with head and neck cancer.
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First-Generation Deescalation Trials in HPV-Positive Oropharyngeal Cancer
This Viewpoint discusses the limitations of precision medicine in patients with human papillomavirus–positive oropharyngeal cancer.
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Blood blister in mouth: Pictures and treatment
Learn about the causes of blood blisters in the mouth, including injury, oral herpes, stress, and oral cancer. How are blood blisters treated?
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Phenotypic expression of a novel desmin gene mutation: hypertrophic cardiomyopathy followed by systemic myopathy
Phenotypic expression of a novel desmin gene mutation: hypertrophic cardiomyopathy followed by systemic myopathy
Phenotypic expression of a novel desmin gene mutation: hypertrophic cardiomyopathy followed by systemic myopathy, Published online: 22 November 2017; doi:10.1038/s10038-017-0383-x
Phenotypic expression of a novel desmin gene mutation: hypertrophic cardiomyopathy followed by systemic myopathy
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Hierarchical semi-Bayes methods for misclassification in perinatal epidemiology
Background: Validation data are used to estimate the extent of misclassification in epidemiologic studies. In the Penn MOMS cohort, prepregnancy BMI is subject to misclassification and validation data are available to estimate the extent of misclassification. We use these data to estimate the association between maternal prepregnancy body mass index and early preterm (
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Can We Train Machine Learning Methods to Outperform the High-dimensional Propensity Score Algorithm?
The use of retrospective healthcare claims datasets is frequently criticized for the lack of complete information on potential confounders. Utilizing patient's health status-related information from claims datasets as surrogates or proxies for mismeasured and unobserved confounders, the high-dimensional propensity score algorithm enables us to reduce bias. Using a previously published cohort study of post-myocardial infarction statin use (1998 - 2012), we compare the performance of the algorithm with a number of popular machine learning approaches for confounder selection in high-dimensional covariate spaces: random forest, least absolute shrinkage and selection operator, and elastic net. Our results suggest that, when the data analysis is done with epidemiologic principles in mind, machine learning methods perform as well as the high-dimensional propensity score algorithm. Using a plasmode framework that mimicked the empirical data, we also showed that a hybrid of machine learning and high-dimensional propensity score algorithms generally perform slightly better than the both in terms of mean squared error, when a bias-based analysis is used. Funding Information: This work was supported by a post-doctoral fellowship from the Canadian Network for Observational Drug Effect Studies (CNODES). CNODES, a collaborating centre of the Drug Safety and Effectiveness Network (DSEN), is funded by the Canadian Institutes of Health Research (CIHR). M.E.K. is a Scientist and Biostatistician at the Centre for Health Evaluation and Outcome Sciences (CHÉOS), faculty of Medicine, UBC. M.P. holds a studentship from the Fonds de Recherche du Québec - Santé (FQR-S). R.W.P. holds the Albert Boehringer I Chair in Pharmacoepidemiology, and is a member of the Research Institute of the McGill University Health Centre, which is supported by core funds from FQR-S. Conflict of Interest: M.E.K. has received accommodation costs from the endMS Research and Training Network (2011, 2012), Statistical Society of Canada (2016) to present at conferences, and from Pacific Institute for the Mathematical Sciences (2013), the Canadian Statistical Sciences Institute (2016) to attend workshops. R. W. P. has received fees for service for consulting from Abbvie, Amgen, Eli Lilly, and Searchlight Pharma, for teaching from Novartis, and for scientific steering committee membership from Pfizer. Availability of Data and Code for Replication Software code hints are provided in the supporting material (as an eAppendix) for implementing the methods. Retrospective population-based cohort Dataset from the Clinical Practice Research Datalink (CPRD) is not publicly available due to patient confidentiality reasons. Mohammad Ehsanul Karim, Assistant professor, School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3; and Scientist / Biostatistician, Centre for Health Evaluation and Outcome Sciences (CHÉOS), St. Paul's Hospital, 588-1081 Burrard St, Vancouver, BC V6Z1Y6, Canada. Email: ehsan.karim@ubc.ca, Tel.: +1604-682-2344 ext. 64251, Fax: +1604-806-8005, ORCiD: 0000-0002-0346-2871 Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Are there differences in treatment effects between labial and lingual fixed orthodontic appliances? A systematic review and meta-analysis
Abstract
Background
An evaluation is made of possible differences in treatment effects between labial and lingual fixed appliances.
Methods
A comprehensive search was made of the PubMed-Medline, Cochrane Library and LILACS databases, with an additional manual search covering the period up until April 2017. There were no restrictions in terms of year of publication or language. Agreement between the authors was quantified by the Cohen kappa statistic. A random-effect model was applied to calculate weighted mean differences with 95% confidence intervals.
Results
A total of 249 patients corresponding to four eligible studies were included in the systematic review. Among the six angles and distances entered in the meta-analysis, a tendency was observed in lingual appliances to increase the interincisal angle (95% CI −0.80-8.99; p = 0.101) and reduce the angle between the major axis of upper central incisor and the sellar-nasion plane - though statistical significance was not reached (95% CI −5.75-0.32; p = 0.079).
Conclusion
The results obtained indicate that treatment with lingual appliances favors incisor tipping by exerting lingual crown torque, but there are no differences in cephalometric values between labial and lingual fixed appliances. Because of the small number of included studies, the results of this meta-analysis should be interpreted with caution. Future research should focus on the generation of a consensus document allowing selection of the type of orthodontic approach not only conditioned to the esthetic requirements of the patient but also considering the characteristics of the malocclusion. On the other hand, standardized international guidelines are lacking; the measurements of angles and distances therefore have to be unified with a view to future investigations.
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Safety of transtympanic application of probiotics in a chinchilla animal model
Abstract
Background
Chronic suppurative otitis media can be recalcitrant and difficult to treat, particularly with the increasing occurrence of antibiotic resistance. Lactobacillus plantarum is a probiotic that has been shown to decrease S. aureus and P. aeruginosa growth in wounds, making it a good candidate for the treatment of chronic suppurative otitis media. However, before it can be applied in the ear, its ototoxicity potential must be evaluated.
Methods
A prospective controlled trial was conducted in a chinchilla animal model at the Animal care research facilities of the Montreal Children's Hospital Research Institute to determine whether Lactobacillus plantarum is ototoxic when applied transtympanically. Ten chinchillas each had one ear randomly assigned to receive 109 CFU/mL of Lactobacillus plantarum solution, while the contralateral ear received saline. Auditory brainstem responses were measured bilaterally at 8, 20, 25 kHz before, at 7–10 days after application, and at 28 days after application of probiotic or saline. Facial nerve and vestibular function were assessed clinically.
Results
There were no statistically significant differences in hearing thresholds between control and experimental ears at 28 days after application. A difference of 11 dB was noted in the 25 kHz range at day 7–10, but resolved by day 28. No animals receiving probiotics developed vestibular nerve dysfunction. There was no histologic evidence of auditory hair cell damaged evidenced by scanning electron microscopy.
Conclusion
Our study suggests that a single application of Lactobacillus plantarum at 109 CFU/mL does not cause ototoxicity in a chinchilla animal model. These preliminary safety evaluations and the pathogen inhibitory effects of L. plantarum demonstrated by previous studies present this probiotic as a candidate of interest for further investigation.
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Jesup community remembers retired dentist found in the Altamaha River
This tragedy on the river took more than just a retired dentist but an extended member of many families across decades. On Sunday, Dr. Gary Lewis disappeared on the Altamaha River.
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The association between income and life expectancy revisited: deindustrialization, incarceration and the widening health gap
Abstract
Background
The health gap between the top and the bottom of the income distribution is widening rapidly in the USA, but the lifespan of America's poor depends substantially on where they live. We ask whether two major developments in American society, deindustrialization and incarceration, can explain variation among states in life expectancy of those in the lowest income quartile. Methods
Life expectancy estimates at age 40 of those in the bottom income quartile were used to fit panel data models examining the relationship with deindustrialization and incarceration between 2001 and 2014 for all US states. Results
A one standard deviation (s.d.) increase in deindustrialization (mean = 11.2, s.d. = 3.5) reduces life expectancy for the poor by 0.255 years [95% confidence interval (CI): 0.090–0.419] and each additional prisoner per 1000 residents (mean = 4.0, s.d. = 1.5) is associated with a loss of 0.468 years (95% CI: 0.213–0.723). Our predictors explain over 20% of the state-level variation in life expectancy among the poor and virtually the entire increase in the life expectancy gap between the top and the bottom income quartiles since the turn of the century. Conclusions
In the USA between 2001 and 2014, deindustrialization and incarceration subtracted roughly 2.5 years from the lifespan of the poor, pointing to their role as major health determinants. Future research must remain conscious of the upstream determinants and the political economy of public health. If public policy responses to growing health inequalities are to be effective, they must consider strengthening industrial policy and ending hyper-incarceration.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2iFC1GH
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Lactobacillus plantarum induces apoptosis in oral cancer KB cells through upregulation of PTEN and downregulation of MAPK signalling pathways.
Lactobacillus plantarum induces apoptosis in oral cancer KB cells through upregulation of PTEN and downregulation of MAPK signalling pathways.
Bioimpacts. 2017;7(3):193-198
Authors: Asoudeh-Fard A, Barzegari A, Dehnad A, Bastani S, Golchin A, Omidi Y
Abstract
Introduction: The oral tumor is the sixth most prevalent type of cancer worldwide and the second leading cause of cancer-related mortality. Although chemotherapy and immunotherapy are the main strategies for the treatment of oral cancer, an emergence of inevitable resistance to these treatment modalities is the major drawback that causes recurrence of the disease. Nowadays, probiotics have been suggested as adjunctive and complementary treatment modalities for improving the impacts of chemotherapy and immunotherapy agents. Probiotics, the friendly microflora in our bodies, contribute to the production of useful metabolites with positive effects on the immune system against various diseases such as cancer. Methods:Lactobacillus plantarum is one of the most important bacteria, which commensally live in the human oral system. In the current study, the impacts of L. plantarum on maintaining oral system health were investigated, and the molecular mechanisms of inhibition of oral cancer KB cells mediated by L. plantarum were evaluated using real-time polymerase chain reaction (PCR) and FACS flow cytometry analyses. Results: Our findings showed that L. plantarum is effective in the signal transduction of the oral cancer cells through upregulation and downregulation of PTEN and MAPK pathways, respectively. Conclusion: Based on the biological effects of oral candidate probiotics candidate bacterium L. plantarum on functional expression of PTEN and MAPK pathways, this microorganism seems to play a key role in controlling undesired cancer development in the oral system. Taken all, L. plantarum is proposed as a potential candidate for probiotics cancer therapy.
PMID: 29159146 [PubMed]
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Current and novel approaches for control of dental biofilm.
Current and novel approaches for control of dental biofilm.
Int J Pharm. 2017 Nov 17;:
Authors: Fernandes T, Bhavsar C, Sawarkar S, D'souza A
Abstract
Insights in oral demographics have revealed that a significant percentage of population faces chronic incidences of oral diseases. The innervation of these oral manifestations is required because untreated conditions may lead to bone loss in the oral cavity and systemic complications. Conventional treatments include surgery of the affected area followed by its management and/or treatment with antibiotics. However, widely used antibiotics like Triclosan have serious side effects including down-regulation of oral keratinocytes and fibroblasts. Thus, novel treatments with more targeted approaches have been under investigation. Treatment modalities like Viral mediated gene delivery, liposomes, nanoparticles, and nanobubbles not only help in management of oral diseases but also aid in reducing the biofilm formed due to bacterial bioburden in the areas less accessible through oral and conventional means. This review focuses on the limitation of conventional treatments and highlights the recent investigations in the use of the novel treatment approaches in order to increase the patient compliance and alleviation of side effects. The authors have also tried to emphasize on the future perspectives of glucansucrase inhibitors, photodynamic therapy and probiotics as targeted drug delivery systems. However, further investigations are necessary for implementation of these novel approaches in the clinical setup.
PMID: 29157962 [PubMed - as supplied by publisher]
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3D printing in education boosted with Wollongong and Maryland centres
Two universities are establishing new 3D printing facilities with the help of funding from significant public grants. In Australia, the University of Wollongong (UOW) in New South Wales is to establish a 3D bio-printing facility following a AU$347,000 grant from the Australian Research Council. In the USA, the University of Maryland, College Park, has opened […]
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Why hip hop fans are falling in love with North Philly rapper Tierra Whack
Pictured here in her Germantown studio, Tierra Whack is a rapper musician with a quirky style for her music videos that blends color and surrealism that is catching viewers' attention. Tierra Whack has a message in her new single.
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Safety, pharmacokinetics, and pharmacodynamics of S-(−)-pantoprazole sodium injections after single and multiple intravenous doses in healthy Chinese subjects
Abstract
Purpose
The objective of this study was to evaluate the safety, pharmacokinetics, and pharmacodynamics of S-(−)-pantoprazole (PPZ) sodium injections following single and multiple intravenous doses in healthy Chinese subjects.
Methods
The dosage groups were set as followed: 20 mg of single and multiple intravenous administration of S-(−)-PPZ, 40 mg of single and multiple intravenous administration of S-(−)-PPZ or pantoprazole, and 80 mg of single dosage group of S-(−)-PPZ. Subjects were sampled for pharmacokinetic analysis and were monitored for 24-h intragastric pH prior to and 48-h intragastric pH after administration for the pharmacodynamic study. The pharmacokinetic and pharmacodynamic parameters were compared between S-(−)-PPZ and PPZ. Safety was evaluated on the basis of adverse events, vital signs, laboratory tests, and physical examination.
Results
All adverse events were mild and of limited duration. Maximum plasma concentration and area under the concentration-time curve for S-(−)-PPZ were dose proportional over the range of 20–80 mg following a single intravenous administration. Elimination rate constant and half-life observed statistical difference from a single dose to multiple doses in 40 mg of S-(−)-PPZ groups. After administration of a single dose, the mean 24-h intragastric pH value was observed higher in 80-mg group than in 40- and 20-mg groups. Slightly increase of intragastric pH was found after a single dose of 40 mg S-(−)-PPZ than 40 mg PPZ; however, the differences were not statistically significant.
Conclusions
Twice daily of 40 mg S-(−)-PPZ sodium injections is effective in achieving satisfying acid inhibition. Compared with plasma R-(+)-PPZ levels, most subjects presented more potent and prolonged suppression of gastric acid of S-(−)-PPZ, while a few subjects showed faster metabolic rate of S-(−)-PPZ in vivo.
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Sinus augmentation and concomitant implant placement in low bone-density sites. A retrospective study on an undersized drilling protocol and primary stability
Abstract
Background
Recently, a torque-measuring micromotor has been shown to provide a reliable, quantitative intraoperative evaluation of bone density and implant primary stability. This may be particularly useful for determining bone quality of residual bone and consequently the most appropriate site preparation in the posterior maxilla, where bone often is of low density and quality.
Purpose
This work aimed to assess the medium-term success of implants placed during 1-stage sinus augmentations using an undersized drilling protocol. In case of low bone density, the relationship between residual bone height (RBH) and primary stability was also investigated.
Materials and methods
Clinical records of patients who underwent sinus augmentation and concomitant implant placement following a 12.5% undersized drilling protocol were retrospectively analyzed. In all patients, bone density measured intraoperatively was ≤ 0.45 g/cm3. A minimum of 60 months of follow-up was required for inclusion.
Results
Records of 106 patients who received 253 implants were reviewed. No significant difference in the implant success rate was found for patients who had less than 4 mm of RBH and those who had more.
Conclusions
Underpreparation of the implant-placement sites enabled achievement of successful implant-supported rehabilitation of the posterior maxilla even when both RBH and bone density were low.
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Publication date: 1 May 2019 Source: Talanta, Volume 196 Author(s): Ruiqing Long, Te Li, Chaoying Tong, Lihui Wu, Shuyun Shi Abstract...
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