Nevin Manimala

Rev Esp Quimioter. 2022 Nov 28:suarez28nov2022. doi: 10.37201/req/107.2022. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate whether early vitamin C and thiamine administration was associated with a lower 28-day and in-hospital mortality in surgical critically ill patients with refractory septic shock.

METHODS: We performed a retrospective before-and-after study on patients with refractory septic shock. According to local protocol, hydrocortisone is initiated in case of refractory septic shock. In January 2017, the protocol was changed and vitamin C and thiamine were included. Patients who were admitted in 2015-2016 and 2017-2018 were included in the control and treatment groups, respectively. The primary end point was 28-day and in-hospital mortality. Secondary end points were ICU mortality, ICU and hospital length of stay, duration of vasopressors and mechanical ventilation, use of renal replacement therapy (RRT), and the modification in serum procalcitonin and SOFA score during the first 72 h.

RESULTS: A total of 120 patients were included (58 in the treatment group and 62 in the control group). Log-rank test in Kaplan-Meier curves showed lower 28-day and in-hospital mortality over time in the treatment group (p=0.021 and p=0.035, respectively) but it not reached statistical significance in ICU mortality over time (p=0.100). The need of RRT was less frequent in treatment group (17.2% vs. 37.1%, p=0.024). There were no differences in other secondary outcomes.

CONCLUSIONS: Intravenous vitamin C and thiamine administration in surgical patients with refractory septic shock may be associated with a lower 28-day and in-hospital mortality. Further prospective studies are needed in refractory septic shock.

PMID:36440551 | DOI:10.37201/req/107.2022

Cardiol Young. 2022 Nov 28:1-6. doi: 10.1017/S1047951122003626. Online ahead of print.

ABSTRACT

BACKGROUND: The transition from residency to paediatric cardiology fellowship is challenging due to the new knowledge and technical skills required. Online learning can be an effective didactic modality that can be widely accessed by trainees. We sought to evaluate the effectiveness of a paediatric cardiology Fellowship Online Preparatory Course prior to the start of fellowship.

METHODS: The Online Preparatory Course contained 18 online learning modules covering basic concepts in anatomy, auscultation, echocardiography, catheterisation, cardiovascular intensive care, electrophysiology, pulmonary hypertension, heart failure, and cardiac surgery. Each online learning module included an instructional video with pre-and post-video tests. Participants completed pre- and post-Online Preparatory Course knowledge-based exams and surveys. Pre- and post-Online Preparatory Course survey and knowledge-based examination results were compared via Wilcoxon sign and paired t-tests.

RESULTS: 151 incoming paediatric cardiology fellows from programmes across the USA participated in the 3 months prior to starting fellowship training between 2017 and 2019. There was significant improvement between pre- and post-video test scores for all 18 online learning modules. There was also significant improvement between pre- and post-Online Preparatory Course exam scores (PRE 43.6 ± 11% versus POST 60.3 ± 10%, p < 0.001). Comparing pre- and post-Online Preparatory Course surveys, there was a statistically significant improvement in the participants’ comfort level in 35 of 36 (97%) assessment areas. Nearly all participants (98%) agreed or strongly agreed that the Online Preparatory Course was a valuable learning experience and helped alleviate some anxieties (77% agreed or strongly agreed) related to starting fellowship.

CONCLUSION: An Online Preparatory Course prior to starting fellowship can provide a foundation of knowledge, decrease anxiety, and serve as an effective educational springboard for paediatric cardiology fellows.

PMID:36440543 | DOI:10.1017/S1047951122003626

Clin Physiol Funct Imaging. 2022 Nov 28. doi: 10.1111/cpf.12803. Online ahead of print.

ABSTRACT

BACKGROUND: Reduced field-of-view DWI could be proved to quantitatively identify thyroid papillary carcinoma and there is no literature regarding the use of T1-mapping to distinguish nodular goiter from thyroid papillary carcinoma.

PURPOSE: To compare T1-mapping with reduced field-of-view DWI in differentiating nodular goiter and thyroid papillary carcinoma.

STUDY TYPE: Prospective study.

POPULATIONS: Ninety-five hospitalized patients with thyroid nodules were were included into the research.

SEQUENCE: All subjects underwent T1WI, T2WI, reduced field-of-view DWI and T1-mapping sequences.

ASSESSMENT: ADC and T1 values of each thyroid nodule were measured respectively. According to pathological results, the thyroid nodules were divided into two groups: Group 1 (nodular goiter) and Group 2 (thyroid papillary carcinoma).

STATISTICAL TESTS: An independent sample t test was used to evaluate the differences of ADC and T1 between two groups. ROC curve was used to analyse the diagnostic efficiency of T1, ADC, Thyroid Imaging Reporting and Data System, T1&ADC.

RESULTS: The T1 and ADC values of nodular goiter were both higher than those of thyroid papillary carcinoma (P < 0.05). The AUC values of T1 & ADC were significantly higher than that of T1 or ADC alone (P < 0.05). The AUC value of T1 & ADC was as same as that of TI-RADS.

CONCLUSION: The combination of T1-mapping and reduced field-of-view DWI could effectively differentiate nodular goiter from thyroid papillary carcinoma. And it has at least the same diagnostic value as the ultrasound based TI-RADS classification. This article is protected by copyright. All rights reserved.

PMID:36440541 | DOI:10.1111/cpf.12803

Bone Jt Open. 2022 Nov;3(11):913-923. doi: 10.1302/2633-1462.311.BJO-2022-0081.R1.

ABSTRACT

AIMS: Studies of infant hip development to date have been limited by considering only the changes in appearance of a single ultrasound slice (Graf’s standard plane). We used 3D ultrasound (3DUS) to establish maturation curves of normal infant hip development, quantifying variation by age, sex, side, and anteroposterior location in the hip.

METHODS: We analyzed 3DUS scans of 519 infants (mean age 64 days (6 to 111 days)) presenting at a tertiary children’s hospital for suspicion of developmental dysplasia of the hip (DDH). Hips that did not require ultrasound follow-up or treatment were classified as ‘typically developing’. We calculated traditional DDH indices like α angle (α_SP), femoral head coverage (FHC_SP), and several novel indices from 3DUS like the acetabular contact angle (ACA) and osculating circle radius (OCR) using custom software.

RESULTS: α angle, FHC, and ACA indices increased and OCR decreased significantly by age in the first four months, mean α_SP rose from 62.2° (SD 5.7°) to 67.3° (SD 5.2°) (p < 0.001) in one- to eight- and nine- to 16-week-old infants, respectively. Mean α_SP and mean FHC_SP were significantly, but only slightly, lower in females than in males. There was no statistically significant difference in DDH indices observed between left and right hip. All 3DUS indices varied significantly between anterior and posterior section of the hip. Mean 3D indices of α angle and FHC were significantly lower anteriorly than posteriorly: α_Ant = 58.2° (SD 6.1°), α_Post = 63.8° (SD 6.3°) (p < 0.001), FHC_Ant = 43.0 (SD 7.4), and FHC_Post = 55.4° (SD 11.2°) (p < 0.001). Acetabular rounding measured byOCR indices was significantly greater in the anterior section of the hip (p < 0.001).

CONCLUSION: We used 3DUS to show that hip shape and normal growth pattern vary significantly between anterior and posterior regions, by magnitudes similar to age-related changes. This highlights the need for careful selection of the Graf plane during 2D ultrasound examination. Whole-joint evaluation by obtaining either 3DUS or manual ‘sweep’ video images provides more comprehensive DDH assessment.Cite this article: Bone Jt Open 2022;3(11):913-923.

PMID:36440537 | DOI:10.1302/2633-1462.311.BJO-2022-0081.R1

J Contemp Dent Pract. 2022 Jul 1;23(7):739-742.

ABSTRACT

AIM: Determination of age is a pivotal part of forensic dentistry. Since many dental age determination methods are invasive, Cameriere introduced a radiographic method where age evaluation was carried out using an orthopantomogram (OPG). An adaptation of the same formula was later formulated by Rai et al. for the Indian population. The aim of the study was to assess the age and to dictate the efficiency of the Indian version of Cameriere’s formula in the Chennai subpopulation.

MATERIALS AND METHODS: This study consisted of radiographs belonging to 50 individuals with an age range of 5-15 years. Radiographs were taken using the OPG and the soft copies obtained were analyzed. The variables such as seven left and right permanent mandibular teeth and the number of teeth with closed apical, and with open apical, ends of roots were examined and measured. The obtained data, after substituting in the formula was statistically analyzed using paired and unpaired t-test and Pearson’s correlation coefficient test.

RESULTS: On comparing dental age and chronological age, statistically significant results were obtained on both sides of the radiograph. Between genders, both sides of the radiograph showed non-significant results. On correlating the sides, the left side showed greater accuracy in age determination compared to the right side of the OPG.

CONCLUSION: Age estimation using Indian-specified formula provides a near good estimate and hence can be a reliable method to measure the chronological age of the participants.

CLINICAL SIGNIFICANCE: The Indian version of the Cameriere’s formula can be used as a rational tool to assess the age of young children and adolescents.

PMID:36440522

J Contemp Dent Pract. 2022 Jul 1;23(7):725-732.

ABSTRACT

AIM: The present study aims to compare advanced platelet-rich fibrin (A-PRF) and conventional blood clot as scaffolds in the regenerative endodontic procedure (REP) and to evaluate their effectiveness in the development of traumatized nonvital immature teeth roots.

MATERIAL AND METHODS: Regenerative endodontic procedure was carried out on 20 traumatized nonvital immature maxillary incisors of 17 patients between the ages of 8 and 12 years. Irrigation with 1.5% sodium hypochlorite (NaOCl) and 17% ethylene diamine tetra-acetic acid was done following minimal mechanical debridement. Canal disinfection was achieved using calcium hydroxide paste. According to the scaffold type, teeth were randomly allocated into A-PRF (n = 10) and conventional blood-clot groups (n = 10). Apical width and root dimensions (length and thickness) were analyzed radiographically and statistically after 3-, 6-, and 12-month follow-up.

RESULTS: Fifteen patients with 18 teeth (A-PRF n = 9, blood clot n = 9) completed the follow-up, and 2 patients were excluded. Patients in both groups were asymptomatic. There was a significant increase within each group in respect to root length, root thickness at one- and two-thirds, and root apex width for all timepoints. While percent of change between the two groups was statistically insignificant.

CONCLUSION: Regenerative endodontic procedure for traumatized immature nonvital teeth with either conventional blood clot or A-PRF as scaffold was comparable, except in cases where adequate bleeding cannot be achieved.

CLINICAL SIGNIFICANCE: Advanced platelet-rich fibrin provides a suitable scaffold that can be used in REP of teeth with close proximity to vital structures such as inferior alveolar nerve (IAN) or mental nerve, where using a sharp instrument to induce bleeding can cause damage and also in cases where adequate bleeding cannot be achieved.

PMID:36440520

J Contemp Dent Pract. 2022 Jul 1;23(7):720-724.

ABSTRACT

AIMS: The aim of this study was to assess subject wise and tooth wise distribution and prevalence of traumatic injuries to the anterior teeth of 2- to 6-year-old children.

MATERIALS AND METHODS: A cross-sectional survey was performed. Primary maxillary and mandibular anterior teeth of 1,800 children aged between 2 years and 6 years, who attended 20 pre-schools in National Capital Region Delhi, India, were examined by a single examiner, and a questionnaire was filled in person by the parent/guardian. Andreasen’s classification was used to classify the traumatic injuries. The Chi-square test was used to statistically analyze the variation in traumatic dental injuries (TDIs) with age and gender. Multiple logistic regression was used to determine the influence of independent variables on the occurrence of TDIs.

RESULTS: The prevalence of TDIs was 17%. Significant and highly significant differences were found between boys and girls for cause and location of trauma (p < 0.05) and tooth type involved (p < 0.001) with boys being more prone to such injuries. The commonest cause of injury was due to falls and the location was playground. The teeth most commonly affected were the maxillary central incisors (36.9%) followed by maxillary lateral incisors (3.3%), and the least affected were the maxillary and mandibular canines (0.3%).

CONCLUSION: The prevalence of traumatic injuries to the anterior teeth in 2- to 6-year-old children in National Capital Region of Delhi, India, was 17%. There is a need to run educational programs to increase parents’ awareness of the risks of dental trauma and emphasize preventive measures.

CLINICAL SIGNIFICANCE: Parents should be made aware of the widespread prevalence, risk factors, and consequences of trauma to primary dentition, so that they can seek appropriate care timely. The time elapsed between injury and dental care is of utmost importance.

PMID:36440519

J Contemp Dent Pract. 2022 Jul 1;23(7):709-712.

ABSTRACT

AIM: The monocyte-to-high-density lipoprotein cholesterol ratio (MHR) has currently been proposed as an indicator of inflammation. The aim of the present study was to assess the relationship between the monocyte-to-high-density lipoprotein cholesterol ratio and periodontal health and disease.

MATERIALS AND METHODS: A total of 90 patients were selected for the study – 30 healthy patients (group I) and 60 periodontitis patients (groups II and III). All the patients were subjected to blood sampling and serum malondialdehyde (MDA), high-density lipoprotein cholesterol (HDL) levels and monocyte counts were estimated.

RESULTS: Monocyte-to-high-density lipoprotein cholesterol ratio was 80.64 ± 28.71 for patients with moderate periodontitis (group II), 95.14 ± 53.21 in severe periodontitis (group III), and 14.28 ± 16.05 for the healthy patients. Monocyte-to-high-density lipoprotein cholesterol ratio values were found to be statistically significantly higher than the control group (p < 0.001). Monocyte-to-high-density lipoprotein cholesterol ratio also showed significantly positive correlation with the severity of periodontitis.

CONCLUSION: Malondialdehyde and MHR are increased in periodontal disease and correlate with severity of the periodontal disease.

CLINICAL SIGNIFICANCE: Monocyte-to-high-density lipoprotein cholesterol ratio is a novel, readily available inflammatory and oxidative stress marker in patients with periodontitis and can be useful to evaluate periodontitis and disease severity.

PMID:36440517

J Contemp Dent Pract. 2022 Jul 1;23(7):688-694.

ABSTRACT

AIM: The purpose of this study is to evaluate presurgical computerized volumetric analysis in secondary alveolar cleft bone grafting (SABG) and the time taken for calculation using cone-beam computed tomography (CBCT) via two different software programs.

MATERIALS AND METHODS: Twelve patients with unilateral alveolar clefts were investigated using CBCT. Two independent investigators did presurgical volumetric analysis for each patient’s CBCT data using two different methods. Method A involved On-Demand 3D software (Cybermed Inc., Korea), while method B involved InVesalius 3 software (CTI, Brazil). The volume outcomes and time spent for measurements were compared between both software programs. Interobserver reliability and descriptive and t-test statistics were computed, and statistical significance was considered when p ≤ 0.05.

RESULTS: There was not a statistically significant difference between clefts’ volumetric measurements by the two methods via both investigators (p = 0.186 and 0.069). However, the difference in time taken for these measurements between the two methods was statistically significant (p < 0.001). Intraclass correlation coefficient (ICC) values indicated excellent interobserver reliability for measurements by method A (ICC ~ 0.998), and moderate reliability for method B (ICC ~ 0.626).

CONCLUSIONS: Both software programs used in this study had comparable volumetric computation. Method B took much less calculating time than method A. The interobserver reliability was high for both methods.

CLINICAL SIGNIFICANCE: These both investigated software programs may show a clinical implication for presurgical alveolar cleft volume measurement, thus reducing the surgical operating time and adequately selecting a donor site with a congruent sufficient amount of bone grafts.

PMID:36440514

J Contemp Dent Pract. 2022 Jul 1;23(7):679-687.

ABSTRACT

AIM: The aim of the present study is to evaluate the effect of Ag-Au NPs formulation as surface pretreatment by assessing the microshear bond strength, ultra-morphological, and elemental characteristics of gold-silver nanoparticle-treated dentin to resin composite with different adhesive modes.

MATERIALS AND METHODS: A total of 60 extracted sound human permanent molars were selected to test the microshear bond strength of composite resin to dentin (40 teeth) and 20 molars were used to assess the ultramorphological and elemental characteristics of silver-gold nanoparticles using environmental scanning electron microscope (ESEM) with energy-dispersive X-ray (EDX) analyzer. The specimens were randomly divided into two main groups according to measured tests either microshear bond strength or elemental analysis. For the bond-strength testing group, 40 teeth were equally distributed into two main groups (20 each) according to dentin-surface pretreatment with or without the use of silver-gold nanoparticles. Then, each group was further divided into two subgroups (10 specimens for each) according to adhesive mode. For ultramorphological and elemental analysis, 20 teeth were equally divided into similar previously mentioned groups according to treatment modalities (5 teeth per group). The multimode bonding agent used in this study was single-bond universal, 3M. The data were collected and statistically analyzed. The significance level was set at p ≤0.05.

RESULTS: The results showed that different etching modes had no statistically significant effect. Also, pretreatment had no statistically significant effect. The interaction between the two variables also had no statistically significant effect. Majority of samples in all groups had mixed failure mode. Ultramorphological examination of the tested samples treated with silver-gold nanoparticles revealed proper dispersion of nanoparticles in dentin.

CONCLUSIONS: The new formulation of silver-gold nanoparticles did not interfere with the bond strength and sealing ability of resin composite restoration in different adhesion modes.

CLINICAL SIGNIFICANCE: The cavity disinfection with silver-gold nanoparticles did not affect the marginal integrity of resin composite restoration. Further studies should be done to evaluate the impact of application of silver-gold nanoparticles in long duration with other adhesive systems in the clinical scenario.

PMID:36440513