Tag: pubmed

BMC Oral Health. 2024 Sep 4;24(1):1036. doi: 10.1186/s12903-024-04791-9.

ABSTRACT

BACKGROUND: Silver diamine fluoride (SDF) is an antimicrobial agent and alternative treatment option that can be used to arrest dental decay. While there is optimism with SDF with regard to caries management, there is no true consensus on the number and frequency of applications for children. The purpose of this study was to examine the effectiveness of 38% SDF to arrest early childhood caries (ECC) at three different application regimen intervals.

METHODS: Children with teeth that met International Caries Detection and Assessment System codes 5 or 6 criteria were recruited from community dental clinics into an open-label, parallel-group, randomized clinical trial from October 2019 to June 2021. Participants were randomized to one of three groups using sealed envelopes that were prepared with one of three regimens inside: visits one month, four months, or six months apart. Participants received applications of 38% SDF, along with 5% sodium fluoride varnish (NaFV), at the first two visits to treat cavitated carious lesions. Lesions were followed and arrest rates were calculated. Lesions were considered arrested if they were hard on probing and black in colour. Statistics included descriptive and bivariate analyses (Kruskal one-way analysis of variance and Pearson’s Chi-squared test). A p-value of ≤ 0.05 was considered significant.

RESULTS: Eighty-four children participated in the study (49 males and 35 females, mean age: 44.4 ± 14.2 months). Treatment groups were well matched with 28 participants per group. A total of 374 teeth and 505 lesions were followed. Posterior lesions represented only 40.6% of affected surfaces. Almost all SDF treated lesions were arrested for the one-month (192/196, 98%) and four-month (159/166, 95.8%) interval groups at the final visit. The six-month group experienced the lowest arrest rates; only 72% (103/143) of lesions were arrested (p < 0.001). The duration of application intervals was inversely associated with improvements in arrest rates for all lesions.

CONCLUSIONS: Two applications of 38% SDF and 5% NaFV in one-month and four-month intervals were comparable and very effective in arresting ECC. Applications six months apart were less effective and could be considered inferior treatment.

TRIAL REGISTRATION: ClinicalTrials.gov NCT04054635 (first registered 13/08/2019).

PMID:39227897 | DOI:10.1186/s12903-024-04791-9

Crit Care. 2024 Sep 4;28(1):293. doi: 10.1186/s13054-024-05057-0.

ABSTRACT

INTRODUCTION: Experimental studies in animals have yielded conflicting results on the role of Tumor Necrosis Factor (TNF) in sepsis and endotoxemia, with some reporting adaptive and others inappropriate effects. A meta-analysis of the available literature was performed to determine the factors explaining this discrepancy.

METHODS: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The protocol was registered with PROSPERO (CRD42020167384) prior to data collection. PubMed and Embase were the databases queried. Risk of bias was evaluated using the SYRCLE Risk of Bias Tool. All animal studies investigating sepsis-related mortality and modified TNF signaling were considered eligible. The exclusion criteria were: lack of mortality data, 7-day mortality rates below 10% in both wild type and TNF-altered pathway animals, and absence of an English abstract. To determine the role of TNF according to the experimental protocol, three approaches were used: first an approach based on the statistical significance of each experiment, then the pooled mortality was calculated, and finally the weighted risk ratio for mortality was assessed.

RESULTS: A total of 175 studies were included in the analysis, comprising a total of 760 experiments and involving 19,899 animals. The main species used were mice (77%) and rats (21%). The most common method of TNF pathway modulation was TNF pathway inactivation that was primarily associated with an inappropriate secretion of TNF. At the opposite, TNF injection was associated with an adaptive role of TNF. Lipopolysaccharide (LPS) injection was the most used stimulus to establish an infectious model (42%) and was strongly associated with an inappropriate role of TNF. Conversely, live bacterial models, especially the cecal ligation and puncture (CLP) model, pneumonia, meningitis, and gastrointestinal infection, were associated with an adaptive role. This was particularly evident for Listeria monocytogenes, Streptococcus pneumoniae.

CONCLUSION: The role of TNF during infection varies depending on the experimental model used. Models that mimic clinical conditions, based on virulent bacteria that cause high mortality even at low inocula, demonstrated an adaptive role of TNF. Conversely, models based on LPS or low-pathogenic live bacteria, administered at doses well above physiological thresholds and combined with early antibiotic therapy, were associated with an inappropriate role.

PMID:39227889 | DOI:10.1186/s13054-024-05057-0

BMC Oral Health. 2024 Sep 3;24(1):1033. doi: 10.1186/s12903-024-04794-6.

ABSTRACT

BACKGROUND: The accuracy of intraoral scanning is critical for computer-aided design/computer-aided manufacturing workflows in dentistry. However, data regarding the scanning accuracy of various adjacent restorative materials and intraoral scanners are lacking. This in vitro study aimed to evaluate the effect of adjacent restorative material type and CEREC’s intraoral scanners on the accuracy of intraoral digital impressions for inlay cavities.

METHODS: The artificial tooth was prepared with an occlusal cavity depth of 2 mm, a proximal box width at the gingival floor of 1.5 mm, and an equi-gingival margin extended disto-occlusally at the transition line angle on both the lingual and buccal sides for an inlay restoration. The adjacent teeth were veneered with crowns made of gold and zirconia, and an artificial tooth (resin) was utilized as the control group. The inlay cavity and adjacent teeth (Gold, Zirconia, and resin) were scanned 10 times using Chairside Economical Restoration of Esthetic Ceramics (CEREC) Primescan (PS), Omnicam (OC), and Bluecam (BC). A reference scan was obtained using a laboratory scanner (3-shape E3). Scanning was performed according to the manufacturer’s instructions, including powder application for the BC group. Standard tesselation language files were analyzed using a three-dimensional analysis software program. Experimental data were analyzed using a two-way analysis of variance and the Tukey’s post-hoc comparison test.

RESULTS: The restorative materials of the adjacent teeth significantly affected the accuracy of the intraoral digital impressions (p < .05). The zirconia group exhibited the highest trueness deviation, followed by the resin and gold groups, with each demonstrating a statistically significant difference (p < .05). The resin group demonstrated the highest maximum positive deviation and deviation in precision. Gold exhibited the lowest average deviation value for trueness compared with those of the other adjacent restorative materials. Intraoral scanner type significantly influenced the trueness and precision of the scan data (p < .05). The average deviation of trueness according to the intraoral scanner type increased in the following order: BC > PS > OC. The average deviation in precision increased in the following order: PS>OC>BC (p < .05).

CONCLUSION: The restorative materials of the adjacent tooth and the type of intraoral scanner affect the accuracy of the intraoral digital impression. The trueness of the digital images of the BC group, obtained by spraying the powder, was comparable to that of the PS group. Among the adjacent restorative materials, zirconia exhibited the lowest trueness. In contrast, PS demonstrated the highest precision among the intraoral scanners, while resin displayed the lowest precision among the adjacent restorative materials.

PMID:39227885 | DOI:10.1186/s12903-024-04794-6

BMC Public Health. 2024 Sep 3;24(1):2392. doi: 10.1186/s12889-024-19848-1.

ABSTRACT

The Sahel is a region particularly characterized by undernutrition in several forms. In Burkina Faso, where several interventions have been carried out across the past several years, the nutritional situation of children under five years of age is still characterized by persistent stunting in the Est, Sahel, and Cascades regions. This study aims to understand the factors associated with the high prevalence of chronic malnutrition in these regions. National nutrition survey data as well as data from the Ministry of Water and Sanitation were used for bivariate and multivariate statistical analyses to identify factors statistically associated with stunting in children aged 0-59 months who participated in the national nutritional surveys from 2009 to 2019. Around one in ten mothers in all regions had no schooling at all. The improving of IYCF practice has a positive impact on the reduction of the prevalence of chronic malnutrition among children in the Cascades, Est and Sahel regions. In the three target regions, gender and province were significantly associated with stunting. Fever, diarrhea, vitamin A supplementation, household size, and maternal education level were also associated with stunting but only in the Sahel and Cascades regions. Overall, the results of the study show that the fight against stunting must be carried out in a multisectoral approach and target certain provinces particularly because stunting is not uniformly present in all provinces.

PMID:39227883 | DOI:10.1186/s12889-024-19848-1

Diabetol Metab Syndr. 2024 Sep 4;16(1):216. doi: 10.1186/s13098-024-01413-w.

ABSTRACT

BACKGROUND: Familial Partial Lipodystrophy (FPLD) is a disease with wide clinical and genetic variation, with seven different subtypes described. Until genetic testing becomes feasible in clinical practice, non-invasive tools are used to evaluate body composition in lipodystrophic patients. This study aimed to analyze the different anthropometric parameters used for screening and diagnosis of FPLD, such as thigh skinfold thickness (TS), Köb index (Köbi), leg fat percentage (LFP), fat mass ratio (FMR) and leg-to-total fat mass ratio in grams (LTR), by dual-energy X-ray absorptiometry, focusing on determining cutoff points for TS and LFP within a Brazilian population.

METHODS: Thirty-seven patients with FPLD and seventy-four healthy controls matched for body mass index, sex and age were studied. Data were collected through medical record review after signing informed consent. All participants had body fat distribution evaluated by skinfolds and DXA measures. Fasting blood samples were collected to evaluate glycemic and lipid profiles. Genetic studies were carried out on all patients. Two groups were categorized based on genetic testing and/or anthropometric characteristics: FPLD+ (positive genetic test) and FPLD1 (negative genetic testing, but positive clinical/anthropometric criteria for FPLD).

RESULTS: Eighteen (48.6%) patients were classified as FPLD+, and 19 (51.4%) as FPLD1. Unlike what is described in the literature, the LMNA variant in codon 582 was the most common. Among the main diagnostic parameters of FPLD, a statistical difference was observed between the groups for, Köbi, TS, LFP, FMR, and LTR. A cutoff point of 20 mm for TS in FPLD women was found, which is lower than the value classically described in the literature for the diagnosis of FPLD. Additionally, an LFP < 29.6% appears to be a useful tool to aid in the diagnosis of these women.

CONCLUSION: Combining anthropometric measurements to assess body fat distribution can lead to a more accurate diagnosis of FPLD. This study suggests new cutoff points for thigh skinfold and leg fat percentage in women with suspected FPLD in Brazil. Further studies are needed to confirm these findings.

PMID:39227868 | DOI:10.1186/s13098-024-01413-w

BMC Res Notes. 2024 Sep 3;17(1):245. doi: 10.1186/s13104-024-06910-9.

ABSTRACT

BACKGROUND: In Nigeria, since 2002, Imatinib mesylate (glivec^®) has been available freely to chronic myeloid leukaemia (CML) patients but only at a tertiary health care centre in the southwestern part of the country. Despite this, it is not readily accessible to many patients due to the distance and other challenges including low socioeconomic status and political problems, preventing timely access to specialist care. This study evaluated the effect of the baseline characteristics on the prognostic implication and treatment outcome of CML patients in Nigeria.

METHOD: This study retrospectively evaluated the baseline characteristics, clinical presentations and treatment outcomes of 889 CML patients over 18 years (2002-2020). Of these, 576 (65%) patients had complete information with up-to-date BCR::ABL1 records. These 576 patients were categorized based on their responses to Imatinib therapy into three groups viz.; Optimal response (OR) defined as BCR::ABL1 ratio of < 0.1% or major molecular remission (≥ 3-log reduction of BCR::ABL1 mRNA or BCR::ABL1 ratio of < 0.1% on the International Scale), Suboptimal response (SR) with BCR::ABL ratio of 0.1-1%, and Treatment failure (TF) when MMR has not been achieved at 12 months. The variables were analyzed using descriptive and inferential statistics and a p-value < 0.05 was considered statistically significant.

RESULTS: The result revealed a median age of 37 years at diagnosis with a male-to-female ratio of 1.5:1. The majority (96.8%) of the patients presented with one or more symptoms at diagnosis with a mean symptom duration of 12 ± 10.6 months. The mean Sokal and EUTOS scores were 1.3 ± 0.8 and 73.90 ± 49.09 respectively. About half of the patients presented with high-risk Sokal (49%) and EUTOS (47%) scores. Interestingly, both the Sokal (r = 0.733, p = 0.011) and EUTOS (r = 0.102, p = 0.003) scores correlated positively and significantly with the duration of symptoms at presentation. Based on response categorization, 40.3% had OR while 27.1% and 32.6% had SR and TF respectively.

CONCLUSION: This study observed a low optimal response rate of 40.3% and treatment failure rate of 32.6% in our CML cohort while on first-line Imatinib therapy. This treatment response is strongly attributable to the long duration of symptoms of 12 months or more and high Sokal and EUTOS scores at presentation. We advocate prompt and improved access to specialist care with optimization of tyrosine kinase inhibitor therapy in Nigeria.

PMID:39227850 | DOI:10.1186/s13104-024-06910-9

Ital J Pediatr. 2024 Sep 4;50(1):163. doi: 10.1186/s13052-024-01728-4.

ABSTRACT

BACKGROUND: Systemic Lupus Erythematosus (SLE) patients are more likely than the general population to suffer from thyroid illness. The major goal was to assess the thyroid dysfunctions due to immunological factors in Egyptian SLE children and how they are related to the course and severity of the illness.

METHODS: Fifty children and adolescents with SLE are included in this cross-sectional observational study. Every patient underwent a thorough physical examination and a comprehensive history taking. An enzyme-linked immunosorbent assay (ELISA) approach was used to evaluate the thyroid profile, anti-thyroglobulin (Anti-TG), and anti-thyroid peroxidase (anti-TPO) antibodies.

RESULTS: Of the 50 patients, the female: male ratio (F: M = 7:1) was 44 females and 6 males (12%). They were between the ages of 5 and 17. Out of the patients, thirty-two (64%) had thyroid dysfunctions, 19 (38%) had euthyroid sick syndrome, ten (20%) had overt hypothyroidism, three (6%) had subclinical hypothyroidism, and none had hyperthyroidism. Of the 50 patients, one (2%) had increased anti-TPO, whereas all other patients had normal anti-TG levels. A statistically significant negative correlation (p-value 0.007) was seen between the disease duration and free thyroxine (FT4). Furthermore, a significant negative correlation (p-values 0.015 and 0.028) was found when comparing the disease duration with thyroid antibodies (anti-TG and anti-TPO).

CONCLUSION: In Juvenile Systemic Lupus Erythematosus (JSLE), thyroid dysfunctions can be identified. The disease duration but not its activity was significantly correlated with thyroid antibodies. For children with JSLE, thyroid function testing should be done on a regular basis. It is preferable to carry out additional thyroid antibody tests when necessary.

PMID:39227847 | DOI:10.1186/s13052-024-01728-4

J Clin Rheumatol. 2024 Sep 3. doi: 10.1097/RHU.0000000000002118. Online ahead of print.

ABSTRACT

BACKGROUND: Familial Mediterranean fever (FMF) is a monogenic autoinflammatory disease, and colchicine is the mainstay of treatment. Approximately 5%-10% of patients may respond inadequately to colchicine, and anti-interleukin-1 (anti-IL-1) agents are important treatment options in these patients. The aim of this study was to see whether there is any factor associated with the withdrawal of these anti-IL-1 agents and to investigate the characteristics of colchicine-resistant FMF patients who needed biological therapy.

METHODS: Demographic, clinical characteristics, and disease severity of patients, at 2 referral centers, between 2012 and 2022, in whom anti-IL-1 treatment was continued and discontinued, were compared in this study. The international severity scoring system for FMF (ISSF) was used for disease severity assessment.

RESULTS: In 64 colchicine-resistant FMF patients, the median (interquartile range) duration of biological treatment was 39 (45) months. Treatment of 26 patients (40.6%) was started with anakinra and 38 (59.4%) with canakinumab. During follow-up, anti-IL-1 treatment was discontinued in 23 patients (35.9%). High ISSF scores before biological treatment, presence of exertional leg pain, subclinical inflammation, and comorbidity were found to be statistically more frequent in the group whose biological therapy could not be discontinued (p = 0.009, p = 0.006, p = 0.026, p = 0.001, respectively).

CONCLUSIONS: Low ISSF scores before biological treatment with no accompanying exertional leg pain, subclinical inflammation, and comorbidities may be stated as an associated factors in terms of the discontinuation of biological agents in colchicine-resistant pediatric FMF patients.

PMID:39226611 | DOI:10.1097/RHU.0000000000002118

Aust J Gen Pract. 2024 Sep;53(9):640-646. doi: 10.31128/AJGP-08-23-6925.

ABSTRACT

BACKGROUND AND OBJECTIVES: Surgical site infection (SSI) after dermatological surgery is associated with poor outcomes. Developing clinical prediction rules based on the predicted probability of infection might encourage guided prophylaxis and judicious prescribing. The purpose of this study was to develop a clinical prediction rule based on identified risk factors for SSI in a large general practice patient cohort.

METHOD: We examined a large, pooled dataset from four randomised controlled trials performed in a regional centre of North Queensland, Australia. Multivariable logistic regression identified a prediction model. Bootstrapping was used for internal validation. A scoring system was based on predicted probabilities of infection.

RESULTS: The final prediction rule included age >55 years and the anatomical site, histology and complexity of the excision. The area under the curve was 0.704.

DISCUSSION: Our prediction rule encourages judicious use of prophylaxis in clinical practice.

PMID:39226598 | DOI:10.31128/AJGP-08-23-6925

Aust J Gen Pract. 2024 Sep;53(9):612-616. doi: 10.31128/AJGP-02-24-7176.

ABSTRACT

BACKGROUND: Melanoma overdiagnosis occurs when melanomas, not destined to cause morbidity or death in a patient’s lifetime, are identified and treated.

OBJECTIVE: This study considers the causes and magnitude of melanoma overdiagnosis in Australia. We also speculate about a possible benefit of overdiagnosis in Australia; namely, a reduction in excess deaths in the geographical areas where melanoma is diagnosed most frequently.

DISCUSSION: Overdiagnosis can arguably be mitigated by factors that reduce the number of lesions treated for each melanoma identified. Data from the Australian Cancer Atlas show that there is a reduction in excess deaths from melanoma in geographical areas where diagnostic rates are higher (Pearson correlation coefficient r=-0.5978, 95% CI: -0.6243 to -0.5699, P<0.0001); this being the strongest inverse correlation observed among the 20 cancer types in the Atlas. Is early diagnosis of actual life-threatening melanomas in these geographical regions impacting survival? Further research is planned.

PMID:39226593 | DOI:10.31128/AJGP-02-24-7176