Sixteen studies were included in this review of oral appliances for sleep bruxism. The included studies were small and mainly short term and only 7 studies were RCTs . Although the availabel evidence suggests a short term benefit further high-quality studies of longer duration are needed.
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An effective rapid-onset treatment for major depressive disorder could save lives. Extensive preclinical and clinical data demonstrate such an action of ketamine. However, the presumptive mechanism of action, inhibition of NMDA (N-methyl-D-aspartate) receptors, has recently been challenged. Elucidation of the mechanism is important clinically for drug discovery and for understanding the (patho)physiology of depression.
The best-known pharmacologic property of ketamine is non-competitive inhibition of the NMDA subtype of glutamate receptor. Although other mechanisms have been postulated, this action has been assumed the major one that accounts for ketamine's antidepressant effect. However, a ketamine metabolite and a different mechanism have now been claimed to be necessary and sufficient for the effect.
A metabolite has been proposed to be responsible for the antidepressant action of ketamine, via activation of non-NMDA receptors. It will be important to determine which of the competing views is correct.
Extensive preclinical and clinical data demonstrate a rapid antidepressant action of ketamine. The presumptive mechanism of action, inhibition of NMDA (N-methyl-D-aspartate) receptors, has recently been challenged because a ketamine metabolite, and a different mechanism, have been claimed to be necessary and sufficient for the effect. Elucidation of the mechanism is important clinically, for drug discovery, and for understanding the (patho)physiology of depression.
It is well known that using proper weights for genetic variants is crucial in enhancing the power of gene- or pathway-based association tests. To increase the power, we propose a general approach that adaptively selects weights among a class of weight families and apply it to the popular sequencing kernel association test. Through comprehensive simulation studies, we demonstrate that the proposed method can substantially increase power under some conditions. Applications to real data are also presented. This general approach can be extended to all current set-based rare variant association tests whose performances depend on variant's weight assignment.
The substantial heritability of most complex diseases suggests that genetic data could provide useful risk prediction. To date the performance of genetic risk scores has fallen short of the potential implied by heritability, but this can be explained by insufficient sample sizes for estimating highly polygenic models. When risk predictors already exist based on environment or lifestyle, two key questions are to what extent can they be improved by adding genetic information, and what is the ultimate potential of combined genetic and environmental risk scores? Here, we extend previous work on the predictive accuracy of polygenic scores to allow for an environmental score that may be correlated with the polygenic score, for example when the environmental factors mediate the genetic risk. We derive common measures of predictive accuracy and improvement as functions of the training sample size, chip heritabilities of disease and environmental score, and genetic correlation between disease and environmental risk factors. We consider simple addition of the two scores and a weighted sum that accounts for their correlation. Using examples from studies of cardiovascular disease and breast cancer, we show that improvements in discrimination are generally small but reasonable degrees of reclassification could be obtained with current sample sizes. Correlation between genetic and environmental scores has only minor effects on numerical results in realistic scenarios. In the longer term, as the accuracy of polygenic scores improves they will come to dominate the predictive accuracy compared to environmental scores.
Genome-wide association studies (GWAS) are now routinely imputed for untyped single nucleotide polymorphisms (SNPs) based on various powerful statistical algorithms for imputation trained on reference datasets. The use of predicted allele counts for imputed SNPs as the dosage variable is known to produce valid score test for genetic association. In this paper, we investigate how to best handle imputed SNPs in various modern complex tests for genetic associations incorporating gene–environment interactions. We focus on case-control association studies where inference for an underlying logistic regression model can be performed using alternative methods that rely on varying degree on an assumption of gene–environment independence in the underlying population. As increasingly large-scale GWAS are being performed through consortia effort where it is preferable to share only summary-level information across studies, we also describe simple mechanisms for implementing score tests based on standard meta-analysis of "one-step" maximum-likelihood estimates across studies. Applications of the methods in simulation studies and a dataset from GWAS of lung cancer illustrate ability of the proposed methods to maintain type-I error rates for the underlying testing procedures. For analysis of imputed SNPs, similar to typed SNPs, the retrospective methods can lead to considerable efficiency gain for modeling of gene–environment interactions under the assumption of gene–environment independence. Methods are made available for public use through CGEN R software package.
Construction of multifactorial disease models from epidemiological findings and their application to disease pedigrees for risk prediction is nontrivial for all but the simplest of cases. Multifactorial Disease Risk Calculator is a web tool facilitating this. It provides a user-friendly interface, extending a reported methodology based on a liability-threshold model. Multifactorial disease models incorporating all the following features in combination are handled: quantitative risk factors (including polygenic scores), categorical risk factors (including major genetic risk loci), stratified age of onset curves, and the partition of the population variance in disease liability into genetic, shared, and unique environment effects. It allows the application of such models to disease pedigrees. Pedigree-related outputs are (i) individual disease risk for pedigree members, (ii) n year risk for unaffected pedigree members, and (iii) the disease pedigree's joint liability distribution. Risk prediction for each pedigree member is based on using the constructed disease model to appropriately weigh evidence on disease risk available from personal attributes and family history. Evidence is used to construct the disease pedigree's joint liability distribution. From this, lifetime and n year risk can be predicted. Example disease models and pedigrees are provided at the website and are used in accompanying tutorials to illustrate the features available. The website is built on an R package which provides the functionality for pedigree validation, disease model construction, and risk prediction. Website: http://ift.tt/2BpbO6M
The expression of X-chromosome undergoes three possible biological processes: X-chromosome inactivation (XCI), escape of the X-chromosome inactivation (XCI-E), and skewed X-chromosome inactivation (XCI-S). Although these expressions are included in various predesigned genetic variation chip platforms, the X-chromosome has generally been excluded from the majority of genome-wide association studies analyses; this is most likely due to the lack of a standardized method in handling X-chromosomal genotype data. To analyze the X-linked genetic association for time-to-event outcomes with the actual process unknown, we propose a unified approach of maximizing the partial likelihood over all of the potential biological processes. The proposed method can be used to infer the true biological process and derive unbiased estimates of the genetic association parameters. A partial likelihood ratio test statistic that has been proved asymptotically chi-square distributed can be used to assess the X-chromosome genetic association. Furthermore, if the X-chromosome expression pertains to the XCI-S process, we can infer the correct skewed direction and magnitude of inactivation, which can elucidate significant findings regarding the genetic mechanism. A population-level model and a more general subject-level model have been developed to model the XCI-S process. Finite sample performance of this novel method is examined via extensive simulation studies. An application is illustrated with implementation of the method on a cancer genetic study with survival outcome.
Tooth loss results in an inevitable alveolar ridge reduction. This has established a cautionary approach to extract, wait, augment, and insert the implant, in lieu of immediate placement. However, saving the tooth or part of it whenever possible is more conservative and supports the vital periodontal tissue buccofacial to an implant. The purpose of this cases series was to report on implant survival using this technique in a large cohort of patients at mid-term follow-up.
A private practice patient database was searched for all patients having received socket-shield treatment in conjunction with immediate implant placement. Of the results returned, 128 met the inclusion criteria of ≥12 months from date of restoration, or failing prior to definitive restoration. These patients were recalled for evaluation of the restored implants up to 4 years post-treatment.
Seventy immediate implants with socket-shields were placed in female patients and 58 in males, age range 24-71 (mean 39 years). The distribution of sites treated were: maxillary incisors (64%), premolars (22%), canines (14%); maxilla (89.9%), mandible (10.1%). 123/128 implants osseointegrated and survived 1-4 years following restoration (survival rate 96.1%). A combined complication rate of 25/128 implants occurred (19.5%). Five implants failed to osseointegrate and were removed. The remaining 20 complications were all managed or observed without management, with implants surviving at mid-term follow-up.
Notwithstanding technique sensitivity and the need for randomized control studies, this case series demonstrates that the socket-shield performs competitively when compared to implant survival rates in both conventional immediate and delayed implant placement.
Hyperemesis gravidarum remains a common, distressing, and significant yet poorly understood disorder during pregnancy. The association between maternal Helicobacter pylori (H. pylori) infection and hyperemesis gravidarum has been increasingly recognized and investigated. This study thus aimed to provide an updated review and meta-analysis of the topic.
Using the search terms (H. pyloriOR Helicobacter ORHelicobacter pyloriOR infection) AND (pregnancy OR emesis OR hyperemesis gravidarum OR nausea OR vomiting), a preliminary search on the PubMed, Ovid, Web of Science, Google Scholar, and WanFang database yielded 372 papers published in English between January 1st, 1960 and June 1st, 2017.
A total of 38 cross-sectional and case-control studies, with a total of 10 289 patients were eligible for review. Meta-analysis revealed a significant association between H. pylori infection and hyperemesis gravidarum during pregnancy, with a pooled odds ratio of 1.348 (95% CI: 1.156-1.539, P < .001). Subgroup analysis found that serologic and stool antigen tests were comparable methods of detecting H. pylori as they yielded similar odds ratios.
Although the studies did not have high heterogeneity (I2 = 28%), publication bias was observed, and interstudy discrepancies in the diagnostic criteria adopted for hyperemesis gravidarum limit the reliability of findings. Also, 15 of the included studies were from the same country (Turkey), which could limit the generalizability of current findings. The prevalence of H. pylori infection varies throughout the world, and there may also be pathogenic differences as most strains of H. pylori in East Asia carry the cytotoxin-associated gene A gene.
H. pylori infection was associated with an increased likelihood of hyperemesis gravidarum during pregnancy. Given the high prevalence of H. pylori infections worldwide, detecting H. pylori infection and the eradication of maternal H. pylori infection could be part of maternal hyperemesis gravidarum management. Further confirmation with robust longitudinal studies and mechanistic investigations are needed.
There is some evidence that prior use of macrolide antibiotics is a useful predictor of the likelihood of standard triple therapy failure in Helicobacter pylori eradication. In this study, we have evaluated whether previous intake of macrolides correlates with failure to eradicate H. pylori using two different first-line clarithromycin-containing regimens.
Retrospective study of 212 patients with H. pylori infection treated with one of two first-line clarithromycin-containing regimens: 108 patients treated with triple therapy for 10 days and 104 patients treated with concomitant therapy for 10 days. The intake of macrolides (clarithromycin, azithromycin, and other macrolides) prior to the eradication therapy was obtained from the electronic medical record, which contains information regarding all the medication prescribed to the patients since the year 2004.
One hundred of 212 patients (47.2%) had received at least one treatment with macrolides during the years prior to the eradication therapy. H. pylori eradication rates were significantly lower in patients with previous use compared to patients without previous use of macrolides, both with triple therapy (60.8% vs 92.9%; P < .0001) and with concomitant therapy (85.7% vs 98.2%; P = .024).
Previous use of macrolides correlates with a low H. pylori eradication rate with triple and concomitant clarithromycin-containing regimens. In addition, our study shows that in patients without previous use of macrolides, triple therapy achieves per-protocol eradication rates over 90%.
You may not want to think about your dental hygiene over the holidays, but without a healthy set of pearly whites , how could you possibly eat all that delicious food you've been dreaming about since last holiday season? Here to help you avoid the withering stare of your dentist, even in the midst of gluttony, is the Ara from Kolibree, a new AI-powered toothbrush that claims to help your teeth stay on the nice list this season. This electric toothbrush will ensure that you're brushing for 2 minutes by staying on for 2 minutes.
Flautist Siddharth Majumdar on balancing a medical practice along with a passion for music that he has inherited from father Ronu Majumdar To most of us, a dentist and a flautist could not seem more far-removed as professions. But ask Siddharth Majumdar, son of legendary bansuri vadak Pandit Ronu Majumdar, and he might have you convinced that the two can work in perfect harmony.
The temporary anchorage devices (TADs) which include miniscrew implants (MSIs) have evolved as useful armamentarium in the management of severe malocclusions and assist in complex tooth movements. Although a m...
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Sirona Dental Systems and Viveve Medical are both healthcare companies, but which is the superior investment? We will contrast the two businesses based on the strength of their institutional ownership, dividends, profitability, risk, valuation, earnings and analyst recommendations. 65.9% of Viveve Medical shares are owned by institutional investors.
Many of us are embarrassed with the bad breath produced in our mouth. It might not be what you ate.
Staff including dentists, hygienists, receptionists and the cleaner at Maltings Dental Practice, in Commericial Road, took up the challenge to keep two exercise bikes moving in their waiting room for 12 hours on Tuesday. The spinathon, which consisted of two bikes borrowed from AUK, was raising funds for as part of Mouth Cancer Action month, which runs throughout November.
Media headlines about Patterson Companies have trended somewhat positive recently, Accern Sentiment Analysis reports. The research group rates the sentiment of media coverage by monitoring more than twenty million blog and news sources in real time.
