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Comparative Effectiveness of Dialysis Modality on Laboratory Parameters of Mineral Metabolism

Am J Nephrol. 2022 Feb 28:1-12. doi: 10.1159/000521508. Online ahead of print.

ABSTRACT

INTRODUCTION: Chronic kidney disease-mineral and bone disorders (CKD-MBD) are prevalent in patients undergoing maintenance dialysis. Yet, there are limited and mixed evidence on the effects of different dialysis modalities involving longer treatment times or higher frequencies on CKD-MBD markers.

METHODS: This cohort study used data from 132,523 incident dialysis patients treated with any of the following modalities: conventional thrice-weekly in-center hemodialysis, nocturnal in-center hemodialysis (NICHD), home hemodialysis (HHD), or peritoneal dialysis (PD) from 2007 to 2011. We used marginal structural models fitted with inverse probability weights to adjust for fixed and time-varying confounding and informative censoring. We estimated the average effects of treatments with different dialysis modalities on time-varying serum concentrations of CKD-MBD markers: albumin-corrected calcium, phosphate, parathyroid hormone (PTH), and alkaline phosphatase (ALP) using pooled linear regression.

RESULTS: Most of the cohort were exclusively treated with conventional in-center hemodialysis, while few were ever treated with NICHD or HHD. At the baseline, PD patients had the lowest mean and median values of PTH, while NICHD patients had the highest median values. During follow-up, compared to hemodialysis patients, patients treated with NICHD had lower mean serum PTH (19.8 pg/mL [95% confidence interval: 2.8, 36.8] lower), whereas PD and HHD patients had higher mean PTH (39.7 pg/mL [31.6, 47.8] and 51.2 pg/mL [33.0, 69.3] higher, respectively). Compared to hemodialysis patients, phosphate levels were lower for patients treated with NICHD (0.44 mg/dL [0.37, 0.52] lower), PD (0.15 mg/dL [0.12, 0.19] lower), or HHD (0.33 mg/dL [0.27, 0.40] lower). There were no clinically meaningful associations between dialysis modalities and concentrations of calcium or ALP.

CONCLUSION: In incident dialysis patients, compared to treatment with conventional in-center hemodialysis, treatments with other dialysis modalities with longer treatment times or higher frequency were associated with different patterns of serum phosphate and PTH. Given the recent growth in the use of dialysis modalities other than hemodialysis, the associations between the treatment and the CKD-MBD markers warrant additional study.

PMID:35226895 | DOI:10.1159/000521508

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Comparative evaluation of complete and partial pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis: A Randomized clinical trial

Int Endod J. 2022 Feb 28. doi: 10.1111/iej.13714. Online ahead of print.

ABSTRACT

AIM: The study aimed to compare the outcome of complete pulpotomy (CP) and partial pulpotomy (PP) techniques, when utilised for the management of mature permanent teeth with carious pulpal exposure and symptomatic irreversible pulpitis (SIP).

METHODOLOGY: The study protocol was registered with ClinicalTrials.gov (NCT04397315). One hundred and six permanent mandibular molars with carious pulpal exposure and clinical diagnosis of SIP with periapical index (PAI) ≤ 2, from patients aged between 18-40 years were randomly allocated in equal proportion to either CP or PP group. Allocated procedures were performed using standardized protocols. The allocated procedure was abandoned in cases where pulpal bleeding could not be controlled within 6 minutes using cotton pellets soaked in 3 % sodium hypochlorite. MTA was used as a pulpotomy agent and teeth were restored using a base of glass ionomer followed by composite restoration. The pain was recorded by the patient preoperatively before administration of local anaesthesia and postoperatively every 24 hours for 1 week using Visual Analogue Scale (VAS). Success was analysed at 12 months based on clinical and radiographic examination. Mann Whitney U test was used to compare age, pain scores, and mean analgesic consumption between the groups. Categorical data were analysed using Chi-square test. Fisher’s exact test was used to assess the clinical and radiographic success and incidence of pain. Kaplan Meier analysis was used to assess the survival of teeth. A p-value <0.05 was considered as statistically significant.

RESULTS: One hundred and one patients were analysed at follow up. Higher success was observed in CP (89.8 %) in comparison to PP group (80.8%), but the difference was non-significant statistically (p=0.202). Although no significant difference was observed in pain incidence between the groups at 24 hours (p=0.496), a significant difference in pain intensities was observed between groups at all the tested time intervals, with lower values reported in CP group (p<0.05).

CONCLUSIONS: Both CP and PP resulted in favourable outcomes in the management of cariously exposed permanent teeth with signs indicative of SIP. Given the more conservative nature of PP, it may be attempted first before proceeding to CP in such cases.

PMID:35226769 | DOI:10.1111/iej.13714

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36-Month Randomized Clinical Trial Evaluation of Preheated and Room Temperature Resin Composite

Oper Dent. 2022 Feb 28. doi: 10.2341/20-301-C. Online ahead of print.

ABSTRACT

OBJECTIVE: This study evaluated the effect of preheating resin composites (RCs) on the clinical performance of class I restorations during a 36-month period using a split-mouth, double-blinded randomized design.

METHODS AND MATERIALS: A total of 35 patients were selected. Every patient received one pair of class I nanofilled resin composite (RC, Filtek Z350 XT) posterior restorations (n=70). One side of the mouth received preheated composites; on the other side, the composite was placed in a nonheated state following the manufacturer’s instructions. These restorations were evaluated at 1-week (baseline), 12-months, 24-months, and 36-months using the FDI World Dental Federation criteria. The statistical analyses were also performed using the Wilcoxon and Friedman tests with the level of significance set at 0.05.

RESULTS: After 36 months, 33 patients attended the recall visits, and 66 restorations were evaluated. The Friedman and Wilcoxon signed-rank tests revealed insignificant differences between both groups (p>0.05) for all FDI parameters. However, a significant difference was detected for staining as a criterion at 36 months (p=0.01). Moreover, a significant difference in the staining was detected when the baseline and 36 months were compared in the nonheated RC group (p=0.001). For esthetic, functional, and biological properties, the nonheated composite exhibited 93.9%, 100%, and 100% of the clinically accepted scores, respectively, and the preheated group presented 100% for all properties. Four restorations had postoperative sensitivity at baseline for nonheated (11.4%) and five for preheated (14.2%), but the postoperative sensitivity scores were considered highly acceptable at 12-, 24-, and 36-months.

CONCLUSIONS: After 36 months, preheated nanofilled RCs showed an acceptable clinical performance similar to that of the nonheated ones in class I restorations, but with better resistance to marginal staining.

PMID:35226749 | DOI:10.2341/20-301-C

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In Vitro Performance of Different Universal Adhesive Systems on Several CAD/CAM Restorative Materials After Thermal Aging

Oper Dent. 2022 Feb 28. doi: 10.2341/20-203-L. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the microshear bond strength (mSBS) of 10 universal adhesive systems applied on five different CAD/CAM restorative materials, immediately and after thermal aging.

METHODS AND MATERIALS: Five CAD/CAM materials were selected: 1) feldspathic glass ceramic (FeCe); 2) pre-polymerized reinforced resin composite (ReRC); 3) leucite-reinforced glass ceramic (LeGC); 4) lithium disilicate (LiDi); and 5) yttrium-stabilized zirconium dioxide (ZiDi). For each material, 15 blocks were cut into four rectangular sections (6 × 6 × 6 mm; n=60 per group) and processed as recommended by the respective manufacturer. For each indirect material, the following adhesive systems were applied according to the respective manufacturer’s instructions: 1) AdheSE Universal [ADU]; 2) All-Bond Universal [ABU]; 3) Ambar Universal [AMB]; 4) Clearfil Universal Bond [CFU]; 5) Futurabond U [FBU]; 6) One Coat 7 Universal [OCU]; 7) Peak Universal Bond [PUB]; 8) Prime&Bond Elect [PBE]; 9) Scotchbond Universal Adhesive [SBU]; 10) Xeno Select [XEN, negative control]. After the application of the adhesive system, cylinder-shaped transparent matrices were filled with a dual-curing resin cement (NX3) and light cured. Specimens were tested in shear mode at 1.0 mm/ min (mSBS), after 24 hours and 10,000 thermal cycles (TC). All data were submitted to statistical analysis (α=0.05).

RESULTS: For FeCe, there was no significant decrease in mean mSBS for AMB, FBU, and SBU after TC when compared at 24 hours. For ReRC, AMB and SBU showed higher mean mSBS when compared to CFU and XEN, after 24 hours and TC. For LiDi, FBU and OCU showed higher mean mSBS when compared to CFU and XEN, after 24 hours and TC. For LeGC, AMB and PUB showed higher mean mSBS when compared to XEN, after 24 hours and TC. For ZiDi, OCU and SBU showed higher mean mSBS when compared to XEN, after 24 hours and TC. In addition, PBE and XEN showed the lowest mean mSBS after TC with higher percentage of bond strength reduction.

CONCLUSIONS: The mean mSBS among the different universal adhesives varied widely for each CAD/ CAM material used. In addition, most universal adhesives underwent a statistically significant bond strength reduction after TC.

PMID:35226751 | DOI:10.2341/20-203-L

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Labiaplasty: Analysis of the National Surgical Quality Improvement Program Database

Aesthet Surg J. 2022 Feb 28:sjac045. doi: 10.1093/asj/sjac045. Online ahead of print.

ABSTRACT

BACKGROUND: Labiaplasty is an increasingly popular procedure performed for both cosmetic and pathologic etiologies. Questions have been raised regarding the efficacy of the procedure, especially for cosmetic etiologies.

OBJECTIVES: To examine the complication profiles of labiaplasties for both cosmetic and pathologic etiologies.

METHODS: The 2005-2017 National Surgical Quality Improvement Program (NSQIP) database was analyzed using Current Procedural Terminology (CPT) codes for patients who underwent labiaplasties. Our cohort was further separated into cosmetic and pathologic groups based on International Classification of Diseases (ICD) codes. Information was collected on patient demographic characteristics, patient comorbidities, and operative variables. Outcomes of interest included surgical complications and delayed length of stay (DLOS). A univariate analysis and multivariate logistic regression were applied to determine statistically significant predictors of our outcomes of interest for both etiologies.

RESULTS: There were 640 patients in the cosmetic cohort and 1919 patients in the pathologic cohort. There were no significant differences in rates of surgical complications between the two groups, but there was a statistically significant increase in length of stay for the pathologic group. Univariate analysis revealed operative time and plastic surgeon specialty to be predictive of DLOS in the cosmetic cohort. No covariates were implicated with multivariate analysis for either surgical complications or DLOS in the cosmetic cohort.

CONCLUSIONS: Our findings suggest that cosmetic labiaplasty is a safe and efficacious procedure with low complication rates and no predictors of adverse outcomes.

PMID:35226721 | DOI:10.1093/asj/sjac045

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Almost all working adults have at least one risk factor for non-communicable diseases: Survey of working adults in Eastern Ethiopia

PLoS One. 2022 Feb 28;17(2):e0264698. doi: 10.1371/journal.pone.0264698. eCollection 2022.

ABSTRACT

INTRODUCTION: The disease burden and mortality related to Non-communicable Diseases (NCD) increased in the last couple of decades in Ethiopia. As a result, an estimated 300,000 deaths per annum were due to NCD. According to a World Health Organization report, 39% of the total deaths in Ethiopia were attributable to NCD. Rapid urbanization characterized by unhealthy lifestyles such as tobacco and/or alcohol use, physical inactivity, low fruits and vegetable consumption, and overweight drive the rising burden of NCD. However, studies on risk factors for NCD and associated variables are limited among working adults in Eastern Ethiopia. Therefore, this study aimed to examine the magnitude of the risk factors of NCD and associated factors among working adults in Eastern Ethiopia.

METHODS: A cross-sectional study was carried out among 1,200 working adults in Eastern Ethiopia that were selected using a simple random sampling technique from December 2018 to February 2019. Data were collected following the World Health Organization Stepwise Approach to NCD Risk Factor Surveillance (WHO STEP) instruments translated into the local language. A total of five risk factors were included in the study. The Negative Binomial Regression Model was used to determine the association between NCD risk factor scores and other independent variables. Adjusted incidence rate ratio (AIRR) with a 95% Confidence Interval (CI) was used to report the findings while the association was declared significant at a p-value of less than 0.05. STATA version 16.1 was used for data clearing, validating and statistical analysis.

RESULTS: Totally, 1,164 (97% response rate) participants were employed for analysis. Overall, 95.8% (95% CI: 94.4-96.7%) of the participants had at least one of the five risk factors of NCD. Furthermore, the proportion of participants that had all NCD risk factors was 0.3%. Among the participants, 47.5% were alcohol drinkers, 5.1% were current smokers, 35.5% were overweight, 49.1% exercise low physical activity, and 95% had less than five portions of fruits and vegetables intake per day. Higher risk factor scores were associated with those of advanced age (AIRR = 1.24; 95% CI: 1.01-1.53 in 35-44 age group and AIRR = 1.28; 95% CI: 1.01-1.62 in 45-54 age group), and the ones who are higher educational level (AIRR = 1.23; 95% CI: 1.07-1.43 for those who have completed secondary school and AIRR = 1.29; 95% CI: 1.11-1.50 for those who have completed college education).

CONCLUSION: The overwhelming majority (95.8%) of the participants had at least one risk factor for non-communicable diseases. The risk score of non-communicable diseases was higher among those with advanced age and who completed secondary and above levels of education. In a nutshell, the finding shows the need for lifestyle modification and comprehensive non-communicable diseases prevention programs for working adults in Eastern Ethiopia.

PMID:35226698 | DOI:10.1371/journal.pone.0264698

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Severe mental illness and pregnancy outcomes in Australia. A population-based study of 595 792 singleton births 2009-2016

PLoS One. 2022 Feb 28;17(2):e0264512. doi: 10.1371/journal.pone.0264512. eCollection 2022.

ABSTRACT

BACKGROUND: Women with Severe Mental Illness (SMI) may have more complex pregnancies and pregnancy outcomes that require different care and management, but this has not been extensively studied. The aim of this study was to explore associations between SMI and adverse maternal and infant outcomes in the state of Victoria, Australia.

METHODS: Our sample included all reported live singleton births in Victoria 2009-2016 (N = 595 792). Associations between SMI and adverse pregnancy outcomes were explored using Odds Ratios (OR), adjusted for sociodemographic and lifestyle factors, and co-morbidities, including any other mental illness.

RESULTS: Of all singleton births, 2046 (0.34%) were to a mother diagnosed with a SMI. We found evidence of an association between SMI and a range of adverse maternal and infant outcomes. Compared to women without SMI, women with a SMI had higher adjusted odds of being admitted to a High Dependency Unit or Intensive Care Unit (aOR 1.83, 1.37-2.43), having gestational diabetes mellitus (1.57, 1.34-1.84), undergoing an unplanned caesarean section (1.17, 1.02-1.33), induction of labour (1.17, 1.05-1.30) and postpartum haemorrhage (1.15, 1.03-1.29). Newborns of women with SMI had higher adjusted odds of being admitted to Special Care Nursery (aOR 1.61, 1.43-1.80), a low Apgar score at 5 minutes (1.50, 1.19-1.90), preterm birth (1.40, 1.20-1.63), and low birthweight (1.26, 1.06-1.49).

CONCLUSION: Women with SMI are at higher risk for a range of adverse maternal and infant outcomes and are a population that may benefit from targeted early identification and enhanced antenatal care.

PMID:35226688 | DOI:10.1371/journal.pone.0264512

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Molecular detection and genetic characterization of small rodents associated Bartonella species in Zhongtiao Mountain, China

PLoS One. 2022 Feb 28;17(2):e0264591. doi: 10.1371/journal.pone.0264591. eCollection 2022.

ABSTRACT

The prevalence and molecular characteristics of Bartonella infections in small rodents in the Zhongtiao Mountain, China have been explored. In this study, the liver, spleen and kidney tissues of captured rodents were used for Bartonella spp. detection and identification by combination of real-time PCR of transfer-mRNA (ssrA) gene and traditional PCR and sequencing of citrate synthase (gltA) gene. It was shown that 49.52% of the rodents (52/105) were positive for Bartonella spp.. The infection rate in different gender (χ2 = 0.079, P = 0.778) and tissues (χ2 = 0.233, P = 0.890) of small rodents did not have statistical difference, but that in different small rodents (Fisher’s exact test, P < 0.001) and habitats (χ2 = 5.483, P = 0.019) had statistical difference. And, the sequencing data suggests that Bartonella sequences (n = 31) were identified into three species, including 14 of B. grahamii, 3 of B. queenslandensis and 14 of unknown Bartonella species. Phylogenetic analysis showed that B. grahamii sequences were clustered with the isolates from South Korea and China, and B. queenslandensis sequences were mainly closely related to the isolates from China and Thailand. The genetic diversity analysis showed that B. grahamii and B. queenslandensis sequences exhibited noticeable intraspecies diversity. Taken together our data demonstrates the high prevalence and genetic diversity of Bartonella infections in small rodents in the Zhongtiao Mountain, especially a potential novel Bartonella specie was detected, which could benefit the prevention and control of rodent-Bartonella species in this area.

PMID:35226692 | DOI:10.1371/journal.pone.0264591

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Application of veterinary naturopathy and complementary medicine in small animal medicine-A survey among German veterinary practitioners

PLoS One. 2022 Feb 28;17(2):e0264022. doi: 10.1371/journal.pone.0264022. eCollection 2022.

ABSTRACT

BACKGROUND: The international use of and interest in veterinary naturopathy and complementary medicine are increasing. There are diverse modes of treatment, and owners seem to be well informed. However, there is a lack of data that describes the state of naturopathic or complementary veterinary medicine in Germany. This study aims to address the issue by mapping the currently used treatment modalities, indications, existing qualifications, and information pathways. In order to map the ongoing controversy, this study records the advantages and disadvantages of these medicines as experienced by veterinarians. Demographic influences are investigated to describe distributional impacts on using veterinary naturopathy and complementary medicine.

METHODS: A standardised questionnaire was used for the cross-sectional survey. It was distributed throughout Germany in a written and digital format from September 2016 to January 2018. Because of the open nature of data collection, the return rate of questionnaires could not be calculated. To establish a feasible timeframe, active data collection stopped when the previously calculated limit of 1061 questionnaires was reached. With the included incoming questionnaires of that day a total of 1087 questionnaires were collected. Completely blank questionnaires and those where participants did not meet the inclusion criteria (were not included, leaving 870 out of 1087 questionnaires to be evaluated. A literature review and the first test run of the questionnaire identified the following treatment modalities: homoeopathy, phytotherapy, traditional Chinese medicine (TCM), biophysical treatments, manual treatments, Bach Flower Remedies, neural therapy, homotoxicology, organotherapy, and hirudotherapy which were included in the questionnaire. Categorical items were processed using descriptive statistics in absolute and relative numbers based on the population of completed answers provided for each item. Multiple choices were possible. Metric data were not normally distributed (Shapiro Wilk Test); hence the median, minimum, and maximum were used for description. The impact of demographic data on the implementation of veterinary naturopathy and complementary techniques was calculated using the Mann-Whitney-U-Test for metric data and the exact Fisher-Test for categorical data.

RESULTS: Overall 85.4% (n = 679 of total 795 non-blank data sets) of all the questionnaire participants used naturopathy and complementary medicine. The treatments most commonly used were complex homoeopathy (70.4%, n = 478), phytotherapy (60.2%, n = 409), classic homoeopathy (44.3%, n = 301) and biophysical treatments (40.1%, n = 272). The most common indications were orthopedic (n = 1798), geriatric (n = 1428) and metabolic diseases (n = 1124). Over the last five years, owner demand for naturopathy and complementary treatments was rated as growing by 57.9% of respondents (n = 457 of total 789). Veterinarians most commonly used scientific journals and publications as sources for information about naturopathic and complementary contents (60.8%, n = 479 of total 788). These were followed by advanced training acknowledged by the ATF (Academy for Veterinary Continuing Education, an organisation that certifies independent veterinary continuing education in Germany) (48.6%, n = 383). The current information about naturopathy and complementary medicine was rated as adequate or nearly adequate by a plurality (39.5%, n = 308) of the respondents of this question. Further, 27.7% (n = 216) of participants chose the option that they were not confident to answer this question and 91 answers were left blank. The most commonly named advantages in using veterinary naturopathy and complementary medicine were the expansion of treatment modalities (73.5%, n = 566 of total 770), customer satisfaction (70.8%, n = 545) and lower side effects (63.2%, n = 487). The ambiguity of studies, as well as the unclear evidence of mode of action and effectiveness (62.1%, n = 483) and high expectations of owners (50.5%, n = 393) were the disadvantages mentioned most frequently. Classic homoeopathy, in particular, has been named in this context (78.4%, n = 333 of total 425). Age, gender, and type of employment showed a statistically significant impact on the use of naturopathy and complementary medicine by veterinarians (p < 0.001). The university of final graduation showed a weaker but still statistically significant impact (p = 0.027). Users of veterinary naturopathy and complementary medicine tended to be older, female, self-employed and a higher percentage of them completed their studies at the University of Berlin. The working environment (rural or urban space) showed no statistical impact on the veterinary naturopathy or complementary medicine profession.

CONCLUSION: This is the first study to provide German data on the actual use of naturopathy and complementary medicine in small animal science. Despite a potential bias due to voluntary participation, it shows a large number of applications for various indications. Homoeopathy was mentioned most frequently as the treatment option with the most potential disadvantages. However, it is also the most frequently used treatment option in this study. The presented study, despite its restrictions, supports the need for a discussion about evidence, official regulations, and the need for acknowledged qualifications because of the widespread application of veterinary naturopathy and complementary medicine. More data regarding the effectiveness and the mode of action is needed to enable veterinarians to provide evidence-based advice to pet owners.

PMID:35226679 | DOI:10.1371/journal.pone.0264022

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Perception towards cardiovascular diseases preventive practices among bank workers in Hossana town using the health belief model

PLoS One. 2022 Feb 28;17(2):e0264112. doi: 10.1371/journal.pone.0264112. eCollection 2022.

ABSTRACT

BACKGROUND: Cardiovascular diseases (CVD) are becoming a public health problem in Ethiopia, especially among those who have limited physical activity. Although bank workers are at an increased risk of contracting CVD, their participation in CVD preventive activities is not studied in Ethiopia. Therefore, this study aimed to assess the perception of bank workers towards CVD preventive behaviors and associated factors in Hossana town.

METHODS: A cross-sectional study was conducted on a sample of 258 participants from February 11 to 30/2020. A simple random sampling method was used to select study participants from the enumerated list of staff. Data was collected using a self-administered structured questionnaire and the collected data was entered and analyzed using SPSS version 20 software. Descriptive statistics and logistic regression analysis were done. A p-value less than 0.05 with 95% CI was considered to declare an association between independent and dependent variables.

RESULTS: A total of 253 respondents with response rate of 98.0% were participated. The study revealed that the likelihood of performing CVD preventive behaviors is 62.0%. Moreover, the study found that bank workers’ exposure to passive smoking [AOR = 0.5; 95% CI: 0.23-0.98], level of alcohol consumed [AOR = 0.5; 95% CI: 0.01-0.54], regularly consuming fruit and vegetable in daily meal [AOR = 0.16; 95% CI: 0.03-0.80], perceived severity[AOR = 0.1;95% CI: 0.01-0.68], and cues to take action [AOR = 0.12;95% CI: 0.02-0.73] were identified as predictors of perception to engage in CVD preventive behaviors.

CONCLUSION: The level of bank workers’ perception of engaging in CVD preventive behavior was in a considerable state to design and implement intervention strategies. Behavior change communication should be strengthened to improve their knowledge and perception of the severity of CVD and barriers so as to improve the likelihood of taking action.

PMID:35226671 | DOI:10.1371/journal.pone.0264112