Nevin Manimala

Braz Oral Res. 2022 Nov 11;36:e137. doi: 10.1590/1807-3107bor-2022.vol36.0137. eCollection 2022.

ABSTRACT

The aim of the present study was to investigate whether possible awake bruxism (AB) is associated with the use of electronic devices and the practice of sports in schoolchildren aged eight to ten years. A cross-sectional study was conducted with 739 students in public and private schools in the city of Campina Grande, Brazil. Parents/guardians answered a questionnaire addressing sociodemographic data. The children answered questions about use of electronic devices, practice of sports, and AB. Statistical analysis involved robust logistic regression for complex samples (α = 5%). The prevalence of possible AB was 14.9%. Being female (OR = 1.71, 95%CI: 1.11-2.63), being the middle child (OR = 2.19, 95%CI: 1.14-3.88), having unmarried parents (OR = 1.73, 95%CI: 1.13-2.65), daily use of a cell phone/tablet/computer (OR = 1.82, 95%CI: 1.19-2.80), use of electronic devices for two or more hours per day (OR = 1.97, 95%CI: 1.35-2.86), and playing sports in and/or out of school (OR = 1.60, 95%CI: 1.18-2.52) remained associated with possible AB in the final model. The presence of possible AB was influenced by the use of electronic devices and the practice of sports among schoolchildren aged eight to ten years.

PMID:36383843 | DOI:10.1590/1807-3107bor-2022.vol36.0137

Braz Oral Res. 2022 Nov 11;36:e129. doi: 10.1590/1807-3107bor-2022.vol36.0129. eCollection 2022.

ABSTRACT

This systematic review evaluated the potential utility of platelet-rich fibrin (PRF) in bone repair in animals. The question is: can the use of PRF in bone defects in healthy rats induce bone repair compared to clot? This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Prisma). The protocol was registered with Prospero (CRD [42020162319]). The literature search involved nine databases, including grey literature. All studies evaluated the bone defects created in rats filled with PRF and clots (control). Biomaterial evaluation was also performed in this study. The risk of bias was assessed using the Systematic Review Center for Laboratory Animal Experimentation (Syrcle) tool for animal studies. A meta-analysis of quantitative data was performed to estimate the effect of PRF on bone repair in rats. Heterogeneity among the studies was assessed using the I2 statistic. The literature search retrieved 685 studies, 10 of which fulfilled the eligibility criteria, and 4 were included in the quantitative assessment. Analysis of the risk of bias revealed that most studies had a high risk of bias in performance and detection. Meta-analysis yielded divergent results and the absence of a statistically significant effect: PRF with control (standardized mean difference 2.54, 95% confidence interval -0.80-5.89; p = 0.14). In general, study heterogeneity was high (I2 ≥ 75.0%). The quality of the studies that influenced the conclusion of the review was based on the PICO, the sources and form of the search, the study selection criteria, the form of evaluation of publication bias, the evaluation of the quality of the studies, and data extraction by two researchers. PRF did not provide significant benefits for bone repair, resulting in unpredictable effects.

PMID:36383835 | DOI:10.1590/1807-3107bor-2022.vol36.0129

Braz Oral Res. 2022 Nov 11;36:e0128. doi: 10.1590/1807-3107bor-2022.vol36.0128. eCollection 2022.

ABSTRACT

The aim of this study was to characterize the salivary metabolomic profile in adolescents with juvenile systemic lupus erythematosus (jSLE). A total of 24 adolescents with jSLE (15.92 ± 2.06 years) and 12 systemically healthy controls (15.25 ± 2.7 years) were included in the study. Participants underwent rheumatologic testing and periodontal examination, with the recording of plaque index (PI), probing depth (PD), clinical attachment level (CAL), and bleeding on probing index (BPI). Unstimulated whole saliva was collected from both groups and stored at -80 ºC. The salivary proton nuclear magnetic resonance (1H-NMR) spectra were acquired in a spectrometer operating at 500 MHz. Partial least squared discriminant analysis (PLS-DA) and orthogonal PLS-DA (O-PLS-DA) were used for statistical analysis. Mean CAL and PI were significantly increased in the group with jSLE (p < 0.01). Patients with jSLE presented a significantly different salivary metabolic profile (accuracy = 0.54; R2 = 0.86; Q2 = -0.293), significantly higher salivary levels of N-acetyl sugars, and significantly reduced levels of phenylalanine, glycine, taurine, hydroxybutyrate, and valerate compared with healthy controls (p < 0.05). It is suggested that the salivary metabolomic profile analyzed by 1H NMR in patients with jSLE presents a different fingerprint that the systemically healthy subjects. Integrating the variation of metabolites with the identification of the metabolic pathways involved seems to provide a better understanding of the influence of systemic disease on salivary metabolites.

PMID:36383834 | DOI:10.1590/1807-3107bor-2022.vol36.0128

Braz Oral Res. 2022 Nov 11;36:e0126. doi: 10.1590/1807-3107bor-2022.vol36.0126. eCollection 2022.

ABSTRACT

The aim of this study was to evaluate the awareness of patients using bisphosphonates (BP) regarding their risks and benefits. Sixty-five patients using BP were included. Each participant completed a self-administered questionnaire consisting of 13 questions, including sociodemographic and general information on BP. Data were analyzed using descriptive statistics, and a binomial test was used to assess patient knowledge about BP, considering a 5% significance level. Fifty-nine (90.2%) patients were unaware or had never heard of BP drugs and only 3 (4.6%) knew their indications. Only 6 patients (9.2%) said they knew about the oral complications caused by BP. Sixty-three patients (96.9%) said they were not referred to the dentist before starting BP treatment. Patients using BP do not have satisfactory knowledge regarding the risks and benefits of BP. Physicians and dentists must be prepared to inform and counsel BP users about their adverse effects and possible risk factors. Our results emphasize the importance of public policies, whether individual or collective, to be taken to increase knowledge about BP to avoid medication-related osteonecrosis of the jaw.

PMID:36383832 | DOI:10.1590/1807-3107bor-2022.vol36.0126

Rev Gaucha Enferm. 2022 Nov 14;43(spe):e20220117. doi: 10.1590/1983-1447.2022.20220117.en. eCollection 2022.

ABSTRACT

OBJECTIVE: To describe and compare the physiological signs presented by premature infants in traditional and humanized weighing.

METHOD: A quasi-experimental crossover study, with a sample of 30 premature infants randomly assigned and allocated to the control group (traditional) and the intervention group (humanized), from March 2019 to March 2020, with the collection of general data, vital signs before and after the procedures. Statistical analyses included description of relative and absolute frequencies, measure of central tendency and dispersion.

RESULTS: Premature infants showed less increase in heart rate (53.3%) and respiratory rate (43%) in the verification of humanized weighing than in the traditional way, with 83.3% of neonates and 80%, respectively.

CONCLUSION: It was observed that the humanized form provided less physiological instability, especially in heart and respiratory rates, making it necessary to encourage discussions about the humanization of care and perform this practice routinely in health units.

PMID:36383829 | DOI:10.1590/1983-1447.2022.20220117.en

Rev Gaucha Enferm. 2022 Nov 14;43(spe):e20210288. doi: 10.1590/1983-1447.2022.20210288.en. eCollection 2022.

ABSTRACT

OBJECTIVE: To analyze the effect of the Patient-Centered Care model on the satisfaction of health professionals, nurses, speech therapists or dentists, who care for hospitalized adults.

METHOD: Systematic Review conducted from October/2020 to March/2021 at PubMed/Medline, CINAHL, EMBASE, SCOPUS, Web of Science and LILACS databases. Observational and interventional studies were included, relating the effect of Patient-Centered Care on the satisfaction of professionals. The Cochrane Collaboration Tool and Meta-Analysis of Statistics Assessment and Review Instrument tools assessed the methodological quality of the studies.

RESULTS: The effect of patient-centered care on job satisfaction was not identified in speech therapists or dentists. Nine selected articles relate it to nurses. Predictors of satisfaction pointed to factors related to interpersonal relationships, patient care and work organization.

CONCLUSION: The Patient-Centered Care model can be a facilitating strategy for nurses’ job satisfaction. However, the current scientific literature still needs further studies to strengthen existing evidence.

PMID:36383823 | DOI:10.1590/1983-1447.2022.20210288.en

Rev Paul Pediatr. 2022 Nov 14;41:e2021352. doi: 10.1590/1984-0462/2023/41/2021352. eCollection 2022.

ABSTRACT

OBJECTIVE: To evaluate the correlation between burden and sleep quality in caregivers of infants with cleft lip and/or palate.

METHODS: This descriptive cross-sectional study was carried out in a Brazilian tertiary public hospital between March and September 2020. The sample included the main informal, literate caregivers of infants with cleft lip and/or palate, aged 18 years or older. The instruments used were the Burden Interview Scale and the Pittsburgh Sleep Quality Index. Data were collected during the infants’ hospitalization. Statistical analysis adopted Pearson and Spearman correlations, with a 5% significance level.

RESULTS: A total of 31 informal caregivers participated in the study, most of them mothers (n=28; 90%), with a mean age of 30 years (standard deviation – SD=7.5), low socioeconomic status (n=20; 64%), who completed high school (n=19; 61%), were married (58%), had two children (n=15; 48%), and no employment relationship (n=18; 58%). A moderate correlation was found between sleep quality and burden (r=0.39; p=0.032) and between burden and subjective sleep quality (r=0.39; p=0.029), sleep latency (r=0.43; p=0.017), and daytime dysfunction (r=0.49; p<0.001).

CONCLUSIONS: The study showed that the higher the burden, the lower the sleep quality. The findings indicate the need to plan and implement interventions to minimize the burden experienced by these informal caregivers in order to improve their sleep quality.

PMID:36383793 | DOI:10.1590/1984-0462/2023/41/2021352

J Urol. 2022 Nov 16:101097JU0000000000003071. doi: 10.1097/JU.0000000000003071. Online ahead of print.

ABSTRACT

PURPOSE: To determine if the AUA recommended prophylaxis (vancomycin + gentamicin alone) for primary inflatable penile prosthesis (IPP) surgery is associated with a higher infection risk than non-standard regimens.

MATERIALS AND METHODS: We performed a multicenter, retrospective study of patients undergoing primary IPP surgery. Patients were divided into those receiving vancomycin + gentamicin alone and those receiving any other regimen. A Cox proportional-hazards model was constructed adjusted for major predictors. A subgroup analysis to identify the appropriate dosage of gentamicin was also performed.

RESULTS: 4,161 patients underwent primary IPP placement (2,411 received vancomycin + gentamicin alone and 1,750 received other regimens). The infection rate was similar between groups, 1 vs 1.2% for standard vs non-standard prophylaxis. In the multivariable analysis, vancomycin + gentamicin (HR: 2.7, 95%CI: 1.4-5.4, P = .004) and diabetes (HR: 1.9, 95%CI: 1.03-3.4, P = .04) were significantly associated with a higher risk of infection. Antifungals (HR: 0.08, 95%CI: 0.03-0.19, P<.001) were associated with lower risk of infection. There was no statistically significant difference in infection rate between weight-based gentamicin compared to 80 mg gentamicin (HR: 2.9, 95% CI: 0.83 to 10, P=.1).

CONCLUSIONS: Vancomycin + gentamicin alone for antibiotic prophylaxis for primary IPP surgery is associated with a higher infection risk than non-standard antibiotic regimens while antifungal use is associated with lower infection risk. A critical review of the recommended antimicrobial prophylactic regimens is needed. Prospective research is needed to further elucidate best practices in IPP antimicrobial prophylaxis.

PMID:36383789 | DOI:10.1097/JU.0000000000003071

J Urol. 2022 Nov 16:101097JU0000000000003069. doi: 10.1097/JU.0000000000003069. Online ahead of print.

ABSTRACT

BACKGROUND: The sentinel reference for antibiotic prophylaxis for radical cystectomy with ileal conduit (RCIC) in the AUA Guidelines reports data from 2003-2013 and has not been updated in the interim. Here, we assess adherence to antibiotic prophylaxis guidelines among patients undergoing radical cystectomy with ileal conduit for bladder cancer using a large national database. As a secondary objective, we assess the association between antimicrobial use and post-operative infection during the index admission following cystectomy.

METHODS: Premier Healthcare Database was queried for all patients undergoing cystectomy with ileal conduit with diagnosis of bladder cancer between 2015 and 2020. Antibiotics used and the duration of use was determined by charge codes and grouped as guidelines-based or not according to 2019 AUA Guidelines. Association with infectious complications was assessed by logistic mixed effects regression models.

RESULTS: Among 6,708 patients undergoing cystectomy with ileal conduit, only 28% (1843/6708) were given prophylaxis according to AUA guidelines. 1.8% (121/6708) of patients received an antifungal, and 37% (2482/6708) received extended duration prophylaxis beyond postoperative day 1. Patients who received guidelines-based prophylaxis were less likely to be diagnosed with a UTI (21% vs 24%, P = .04), pyelonephritis (5.1% vs 7.7%, P<.001), bacterial infection (24% vs 27%, P = .03), or pneumonia (12% vs 17%, P<.001). There was no statistically significant difference in clostridium difficile infection between guidelines-based and non-guidelines-based prophylaxis (3.2% vs 3.7%, P = .32). In a multivariable logistic regression adjusting for age, race, insurance, and hospital and provider characteristics, non-guideline antibiotic prophylaxis (OR 1.27 [1.12, 1.43], P<.001) was associated with an increased odds of infectious events, whereas a robotic approach (OR 0.82 [0.73, 0.92], P<.001) was associated with lower odds.

CONCLUSION: 73% of patients fail to receive guideline-based antibiotic prophylaxis when undergoing radical cystectomy with conduit, which was largely driven by extended duration antibiotic use. Despite the shorter duration of antibiotics, we found that guideline-based prophylaxis was associated with a 25% decrease in the odds of infectious complications. While residual confounding is possible, these data support current AUA guidelines and suggest a need for outreach to improve guideline adherence.

PMID:36383758 | DOI:10.1097/JU.0000000000003069

Clin Chem Lab Med. 2022 Nov 17. doi: 10.1515/cclm-2022-1006. Online ahead of print.

ABSTRACT

OBJECTIVES: Early recognition and timely intervention for urosepsis are key to reducing morbidity and mortality. Blood culture has low sensitivity, and a long turnaround time makes meeting the needs of clinical diagnosis difficult. This study aimed to use biomarkers to build a machine learning model for early prediction of urosepsis.

METHODS: Through retrospective analysis, we screened 157 patients with urosepsis and 417 patients with urinary tract infection. Laboratory data of the study participants were collected, including data on biomarkers, such as procalcitonin, D-dimer, and C-reactive protein. We split the data into training (80%) and validation datasets (20%) and determined the average model prediction accuracy through cross-validation.

RESULTS: In total, 26 variables were initially screened and 18 were statistically significant. The influence of the 18 variables was sorted using three ranking methods to further determine the best combination of variables. The Gini importance ranking method was found to be suitable for variable filtering. The accuracy rates of the six machine learning models in predicting urosepsis were all higher than 80%, and the performance of the artificial neural network (ANN) was the best among all. When the ANN included the eight biomarkers with the highest influence ranking, its model had the best prediction performance, with an accuracy rate of 92.9% and an area under the receiver operating characteristic curve of 0.946.

CONCLUSIONS: Urosepsis can be predicted using only the top eight biomarkers determined by the ranking method. This data-driven predictive model will enable clinicians to make quick and accurate diagnoses.

PMID:36383696 | DOI:10.1515/cclm-2022-1006