Category: Nevin Manimala

Orv Hetil. 2023 Jan 15;164(2):57-63. doi: 10.1556/650.2023.32672. Print 2023 Jan 15.

ABSTRACT

INTRODUCTION: Reflux disease has become endemic in the Western world. High quality hiatal reconstruction and fundoplication has a paramount importance in its therapy. While the primary goal of surgery is reducing reflux-associated disease burden, the evaluation and follow-up of disease-associated quality of life is essential.

OBJECTIVE: In this study, we aimed to measure and evaluate the pre- and post-operative reflux-associated quality of life of patients undergoing surgery between 01. 12. 2015 and 31. 12. 2020 at a tertiary care hospital.

METHOD: We utilized a health-related quality of life questionnaire both pre- and post-operatively. The main outcome measures were: patient-assessed heartburn, dysphagia, regurgitation, chest pain, nausea and vomiting. We also measured acid secretory medication use and patient satisfaction.

RESULTS: We have assessed the pre- and post-operative questionnaries of 65 patients. All the symptoms above have decreased after surgery, and the changes were statistically significant (except for dysphagia). There was a tendency for minor weight loss after surgery. The use of acid secretion inhibitor medications decreased significantly.

DISCUSSION: Our results are comparable to the outcomes of other tertiary care centers. Our workgroup has successfully adopted the diagnostic and therapeutic algorithms of the surgical care of reflux disease.

CONCLUSION: If the proper indications for surgery are met, laparoscopic hiatoplasty and Toupet fundoplication are capable tools in decreasing reflux-associated symptoms and improving reflux-associated quality of life. Orv Hetil. 2023; 164(2): 57-63.

PMID:36641757 | DOI:10.1556/650.2023.32672

Cell Rep. 2023 Jan 13;42(1):111980. doi: 10.1016/j.celrep.2022.111980. Online ahead of print.

ABSTRACT

In the conventional model of transcriptional activation, transcription factors bind to response elements and recruit co-factors, including histone acetyltransferases. Contrary to this model, we show that the histone acetyltransferase KAT7 (HBO1/MYST2) is required genome wide for histone H3 lysine 14 acetylation (H3K14ac). Examining neural stem cells, we find that KAT7 and H3K14ac are present not only at transcribed genes but also at inactive genes, intergenic regions, and in heterochromatin. KAT7 and H3K14ac were not required for the continued transcription of genes that were actively transcribed at the time of loss of KAT7 but indispensable for the activation of repressed genes. The absence of KAT7 abrogates neural stem cell plasticity, diverse differentiation pathways, and cerebral cortex development. Re-expression of KAT7 restored stem cell developmental potential. Overexpression of KAT7 enhanced neuron and oligodendrocyte differentiation. Our data suggest that KAT7 prepares chromatin for transcriptional activation and is a prerequisite for gene activation.

PMID:36641753 | DOI:10.1016/j.celrep.2022.111980

Med Oral Patol Oral Cir Bucal. 2023 Jan 15:25549. doi: 10.4317/medoral.25549. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to evaluate the clinicopathological features of mucocutaneous diseases with manifestation in the head and neck region.

MATERIAL AND METHODS: A retrospective analysis of a dermatology reference center database was carried out. Over 24 years. Clinicopathological data were collected from medical records and the data was analyzed by descriptive statistics.

RESULTS: A total of 11.538 medical records were analyzed, being 152 cases of mucocutaneous diseases with manifestations in the head and neck region. Cutaneous lupus erythematosus was the most prevalent diagnosis (66.4%). Face (44.1%), females (79.6%), and patients with 45 years mean age were the most common features. In the oral cavity, the most affected region was the buccal mucosa (37.5%).

CONCLUSIONS: Mucocutaneous diseases with head and neck manifestation were rare in the sample analyzed (1.3%), with cutaneous lupus erythematosus and lichen planus being the most common lesions in this region.

PMID:36641747 | DOI:10.4317/medoral.25549

Med Oral Patol Oral Cir Bucal. 2023 Jan 15:25774. doi: 10.4317/medoral.25774. Online ahead of print.

ABSTRACT

BACKGROUND: Knowledge of oral mucosal lesions (OMLs) among dentists is relevant in diagnosing potentially malignant diseases and oral cancer at an early stage. The aim of this survey was to explore dentists’ knowledge about OMLs.

MATERIAL AND METHODS: Respondents to a web-based questionnaire, containing 11 clinical vignettes representing patients with various OMLs, provided a (differential) diagnosis and management for each. Information about demographics and clinical experience of the participants was acquired as well. Descriptive statistics were performed and T-tests were used to test for significant (p<0.05) differences in mean scores for correct diagnosis and management between subgroups based on demographic variables.

RESULTS: Forty-four of 500 invited dentists completed the questionnaire. For (potentially) malignant OMLs, the number of correct diagnoses ranged from 14 to 93%, whilst the number of correct management decisions ranged from 43 to 86%. For benign OMLs, the number of correct diagnoses and management decisions ranged from 32 to 100% and 9 to 48%, respectively. For 11 clinical vignettes, mean scores for correct diagnosis, correct management and correct diagnosis and management were respectively 7.2 (±1.8), 5.7 (±1.5), and 3.8 (±1.7).

CONCLUSIONS: The results show that dentists in the Netherlands do not have sufficient knowledge to accurately diagnose some OMLs and to select a correct management. This may result in over-referral of benign OMLs and under-referral for (potentially) malignant OMLs. Clinical guidelines, that include standardized criteria for referral, and continuing education, may improve dentists’ ability to correctly diagnose and accurately manage OMLs.

PMID:36641742 | DOI:10.4317/medoral.25774

Med Oral Patol Oral Cir Bucal. 2023 Jan 15:25773. doi: 10.4317/medoral.25773. Online ahead of print.

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) is the cause of the ongoing coronavirus disease 2019 (COVID-19) pandemic. It has been hypothesized oral health may be related to the severity and complications of COVID-19. The aim of this study was to analyze the prevalence of apical periodontitis and the frequency of root canal treatment in a sample of patients with SARS-CoV-2 infection (COVID-19), correlating them with the severity of the disease.

MATERIAL AND METHODS: This retrospective study was conducted following the Strengthening Reporting Observational Studies in Epidemiology (STROBE) guidelines. The study examined 280 patients with positive real time PCR COVID-19 test whose treatment was performed in our hospital. Fifty-two patients aged 52.3 ± 17.3 years, including 30 males and 22 females, who had an orthopantomography in their clinical record, performed in the last 2 years, were included. Patients with SARS-CoV-2 infection were grouped as mild or moderate (MM) and severe or critical (SC) illness groups, according to the NIH COVID-19 Treatment Guidelines (Wu & McGoogan 2020). Radiographic records were analyzed and apical periodontitis (AP) was diagnosed as radiolucent periapical lesions (RPLs), using the periapical index score (PAI). Student’s t test, χ2 test and multivariate logistic regression were used in the statistical analysis.

RESULTS: The number of carious teeth was significantly higher in the SC group (3.4 ± 4.1), which showed more than twice as many teeth with carious lesions than the MM group (1.4 ± 1.8) (p = 0.02). Multivariate regression analysis showed association between the number of carious teeth and the severity of SARS-CoV-2 disease (OR = 1.5; 95% CI = 1.1-2.1; p = 0.017). Endodontic status (OR = 7.12; 95% CI = 1.2-40.9; p = 0.027) also correlated with the disease severity.

CONCLUSIONS: The results suggest that the oral health status of COVID-19 patients correlated with the severity of the SARS-CoV-2 virus infection. Significant association has been found between the severity of COVID-19 disease and the presence of a greater number of teeth with caries lesions, as well as with endodontic status.

PMID:36641741 | DOI:10.4317/medoral.25773

Med Oral Patol Oral Cir Bucal. 2023 Jan 15:25733. doi: 10.4317/medoral.25733. Online ahead of print.

ABSTRACT

BACKGROUND: Osteonecrosis of the jaw (ONJ) has a frequent adverse effect after the administration of nitrogenous bisphosphonates, as non-nitrogenous bisphosphonates are metabolized more rapidly and would produce this effect to a lesser extent. The objective of this study is to analyze the results obtained in the literature with the use of L-PRF in the treatment of ONJ through a systematic review and meta-analysis.

MATERIAL AND METHODS: Medline (via PubMed), Cochrane, Web of Science and Grey Literature Database was screened from which 10 were selected.

RESULTS: In the meta-analysis with full resolution, combining the use of L-PRF in the treatment of ONJ, a weighted proportion (PP) of 94.3% of complete resolution is obtained (95% CI: 91.2-97.4, p<0.001), with a low degree of heterogeneity, statistically significant (I2 = 29.02%; p<0.001). When analyzing the non-resolution data, a weighted proportion (PP) of 7.7% (95% CI: 3.6-11.9; p<0.001) was obtained with moderate heterogeneity (I2: 41.87%; p=0.112). In the meta-regression, no significant correlation was found between complete resolution and year of publication (intercept = 2.88, p=0.829). In consistency analysis no major changes in PP are identified when any of the studies are eliminated, demonstrating a high reliability in the combined results.

CONCLUSION: L-PRF alone or in combination with other therapies in treatment of ONJ achieved high percentages of complete lesion resolution (94.3%). In studies where L-PRF is combined with other therapies, and where the effectiveness of the other therapy alone is analyzed, L-PRF has been shown higher percentages of resolution.

PMID:36641740 | DOI:10.4317/medoral.25733

Med Oral Patol Oral Cir Bucal. 2023 Jan 15:25760. doi: 10.4317/medoral.25760. Online ahead of print.

ABSTRACT

BACKGROUND: The aim was to assess periodontal health maintenance and gingival recessions development in patients undergoing an orthodontic treatment with clear aligners (CA) and fixed appliances (FA).

MATERIAL AND METHODS: An electronic search in MEDLINE, Scopus, The Cochrane Library, and Web of Science was performed up to September 2022 to identify all potential articles. Two investigators independently selected the studies according to the inclusion criteria. Prospective and retrospective studies assessing the periodontal health status and gingival recession development during the orthodontic treatment with buccal FA and CA were included. Case series, cross-sectional studies, and studies with less than two months of follow-up were excluded. Two investigators independently extracted the data from included articles and assessed risk of bias across studies using the Cochrane Collaboration tool. Qualitative and quantitative analyses of the data were performed. Pairwise meta-analysis using a random-effects model were used to compare periodontal indices between FA and CA treatment in different follow-up periods.

RESULTS: From the 129 potential studies, finally 12 studies were included. Only 8 could be included in the quantitative analysis. CA seems to slightly maintain better periodontal health indices. Only plaque index in a mid-term follow-up (mean difference (MD): -0.99; 95%; Confidence interval (CI) [-1.94 to -0.03]; P=.04; I2=99%), and pocket probing depth at a long-term follow-up (MD: -0.93mm; 95% CI [-1.16 to 0.7]; P<0.0001) reported statistically significant results favoring CA.

CONCLUSIONS: Up to the date there is not enough evidence to conclude that CA maintains better periodontal health during an orthodontic treatment than FA.

PMID:36641738 | DOI:10.4317/medoral.25760

Work. 2023 Jan 10. doi: 10.3233/WOR-220172. Online ahead of print.

ABSTRACT

BACKGROUND: Many individuals experience visual symptoms associated with near work. The level of discomfort appears to increase with the amount of digital screen use.

OBJECTIVE: To study the eye discomfort with near tasks in university students in the pre-COVID period and in the period of confinement due to the pandemic.

METHODS: Two independent samples of students, aged between 18 and 35 years, were used to assess symptomatic behaviour with the Convergence Insufficiency Symptom Survey (CISS) questionnaire. In the pre-COVID period the sample had 342 participants, 64.6% females and in the COVID period 322 students participated, 71.4% females. The study of differences was carried out by the Mann-Whitney U test. The interpretation of the statistical inference was performed for a significance level≤0.05.

RESULTS: There was an increase in the number of symptomatic cases in the COVID period without statistical evidence of differences in the frequency of symptoms reported in the two periods. The dimensions “somatic sensations” and “cognitive performance” were the typology of symptoms that most contributed to visual complaints with near vision. There was a significantly different symptomatic behaviour between genders in the period of confinement (p = 0.001), worsening in females and improving in males.

CONCLUSION: These findings suggest that females and males exposed to digital environments, over time, may exhibit different symptomatic behaviour. Our results suggest that boys adapt more quickly than girls. Factors that predispose to these changes, aetiology and potential intervention actions still need further study.

PMID:36641726 | DOI:10.3233/WOR-220172

Work. 2023 Jan 9. doi: 10.3233/WOR-220132. Online ahead of print.

ABSTRACT

BACKGROUND: Modern medical education has flourished with an emergent interest in a variety of assessment approaches that entails direct observation of performance and provision of feedback. Workplace-based assessment (WPBA) has been embraced into specialty training in the United Kingdom (UK) within National Health Service (NHS). In Pakistan, this educational framework is incorporated to gauge the clinical proficiency of trainees at the postgraduate and undergraduate levels. The present study was done to identify how WPBA is perceived by dental field postgraduate trainees in Pakistan.

OBJECTIVE: The study explored and ascertained trainees’ perceptions, attitudes, and preferences considering their experiences with the systematic organization and execution of WPBA in dental educational settings.

METHOD: This cross-sectional study design involved the clinical trainees of various cadres in a tertiary care hospital in Multan. A structured and validated questionnaire previously used for another analysis was administered among 90 trainees at the institute. The results were analyzed and tabulated using SPSS-21. Influential statistics (Pearson’s Chi-Square Test) was performed and the confidence interval was set at 95% (P≤0.05).

RESULTS: The response rate was 88%. Opinions were more positive compared to the former surveys. The majority of the respondents (65.8%) have shown a positive attitude towards WPBA and preferred it to be a valuable assessment system as it fosters reflective practices in educational settings. In addition, it was shown that WPBA has the potential to improve clinical training (72.2%) and aid in the effective implementation of clinical practice (68.4%). As the system of digital education has been introduced ever since the pandemic, the highest percentage of participants (56%) preferred a combination of on-paper and online assessment systems.

CONCLUSION: The study reported that WPBA proposes the opportunity to associate teaching, learning, and assessment. The faculty training program is a significant input to upholding the quality of WPBA. Empirical research on WPBA is essential to be carried out to overcome the inadequacies thus endorsing its application universally.

PMID:36641724 | DOI:10.3233/WOR-220132

Work. 2023 Jan 9. doi: 10.3233/WOR-211462. Online ahead of print.

ABSTRACT

BACKGROUND: Health literacy plays a key role in promoting overall health and preventing diseases among individuals and communities. However, the literature regarding health literacy among university employees is still evolving and not thoroughly understood.

OBJECTIVE: This study was conducted to examine the association between health literacy and sociodemographic characteristics and nutritional status of university employees in Jordan.

METHODS: This study was conducted using a cross-sectional design. A total of 163 university employees participated by completing a demographics questionnaire and the Health Literacy Questionnaire. The Health Literacy Questionnaire is considered a comprehensive tool to assess health literacy, and it encompasses nine distinct scales. The body mass index was calculated by obtaining the participants’ height and weight.

RESULTS: The results of multivariate analysis of variance showed that three factors had a statistically significant effect on the linear composite of the Health Literacy Questionnaire scales. These factors were the university employees’ age, highest level of education, and body mass index. Follow-up analyses revealed that university employees’ sociodemographic characteristics and nutritional status affect different domains of health literacy. Compared to overweight employees, those with normal body mass index had higher mean average scores on six (out of nine) scales of the Health Literacy Questionnaire.

CONCLUSION: These results highlight the need for addressing the nutritional status and sociodemographic characteristics as a source of disparity in university employees’ health literacy. Such factors should be addressed in designing tailored health promotion interventions for university employees.

PMID:36641716 | DOI:10.3233/WOR-211462