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Nevin Manimala Statistics

Bacteraemia of oral origin in children – A Systematic review and Network meta-analysis

Oral Dis. 2021 Jul 10. doi: 10.1111/odi.13957. Online ahead of print.

ABSTRACT

OBJECTIVES: To systematically review the prevalence of bacteraemia, triggered by dental intervention and home oral hygiene practices, in children. The network meta-analysis (NMA) quantitatively compared the risk of bacteraemia triggered by dental extractions and home and professional cleaning procedures.

MATERIALS AND METHODS: Clinical trials with the outcome ‘bacteraemia in children’ were searched. The NMA was performed using the frequentist weighted least-squares approach comparing the odds ratios (OR) of different interventions.

RESULTS: Among 11 of 13 studies, dental treatment was performed under general anaesthesia. In 2,381 patients, bacteraemia occurred in 38.7-56% patients following single-tooth extractions, in 22-46% after manual toothbrushing (MTB), and in 26-78% after power toothbrushing (PTB). When MTB was set as the reference (OR 1), rubber cup polishing showed a slightly higher risk (OR 1.26) of bacteraemia. PTB presented a higher risk (OR 1.79-2.27) than with single-tooth extractions (OR 1.55) but lower than that with multiple extractions (OR 2.55).

CONCLUSION: Daily use of MTB and routine professional cleaning were associated with the lowest risk of developing bacteraemia in children with gingivitis, almost as much as with a single-tooth extractions. Improved plaque control with PTB increased the risk of bacteraemia. There is limited evidence on gingivitis-free and systemically-diseased children.

PMID:34245644 | DOI:10.1111/odi.13957

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Nevin Manimala Statistics

Connectome analysis of male world-class gymnasts using probabilistic multishell, multitissue constrained spherical deconvolution tracking

J Neurosci Res. 2021 Jul 10. doi: 10.1002/jnr.24912. Online ahead of print.

ABSTRACT

In athletes, long-term intensive training has been shown to increase unparalleled athletic ability and might induce brain plasticity. We evaluated the structural connectome of world-class gymnasts (WCGs), as mapped by diffusion-weighted magnetic resonance imaging probabilistic tractography and a multishell, multitissue constrained spherical deconvolution method to increase the precision of tractography at the tissue interfaces. The connectome was mapped in 10 Japanese male WCGs and in 10 age-matched male controls. Network-based statistic identified subnetworks with increased connectivity density in WCGs, involving the sensorimotor, default mode, attentional, visual, and limbic areas. It also revealed a significant association between the structural connectivity of some brain structures with functions closely related to the gymnastic skills and the D-score, which is used as an index of the gymnasts’ specific physical abilities for each apparatus. Furthermore, graph theory analysis demonstrated the characteristics of brain anatomical topology in the WCGs. They displayed significantly increased global connectivity strength with decreased characteristic path length at the global level and higher nodal strength and degree in the sensorimotor, default mode, attention, and limbic/subcortical areas at the local level as compared with controls. Together, these findings extend the current understanding of neural mechanisms that distinguish WCGs from controls and suggest brain anatomical network plasticity in WCGs resulting from long-term intensive training. Future studies should assess the contribution of genetic or early-life environmental factors in the brain network organization of WCGs. Furthermore, the indices of brain topology (i.e., connection density and graph theory indices) could become markers for the objective evaluation of gymnastic performance.

PMID:34245603 | DOI:10.1002/jnr.24912

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Nevin Manimala Statistics

Survival and prognostic factors of managing cracked teeth with reversible pulpitis: a 1- to 4- year prospective cohort study

Int Endod J. 2021 Jul 10. doi: 10.1111/iej.13597. Online ahead of print.

ABSTRACT

AIM: This prospective clinical study evaluated the clinical performance of managing cracked teeth with reversible pulpitis through a combination of internal and external splinting and investigated factors that can affect pulp survival after splinting.

METHODOLOGY: Thirty-four teeth diagnosed with cracks and reversible pulpitis were enrolled and treated with bidirectional crack splinting: 1) immediate splinting with a stainless-steel band; 2) internal splinting with crack line removal and resin filling; and 3) external splinting with a temporary crown followed by final crown setting. If the symptoms remained/recurred, root canal treatment was performed. Patients were followed up at 3, 6, and 12 months, then annually thereafter. Kaplan-Meier survival analysis to calculate the survival of the treated teeth and Cox univariate proportional hazards regression model to investigate prognostic factors were performed.

RESULTS: Twenty-nine (97%) teeth were followed up for up to 4 years. The pulp survival rate was 72% after banding and 91% after final crown cementation. No tooth was extracted (100% tooth survival rate). In the univariate Cox proportional hazard test, pain on percussion was the only statistically significant factor (hazard ratio = 11.77). Teeth with pain on percussion at the first visit had a pulp survival rate of 46% during the follow-up period. In comparison, their counterparts without pain had a 94% pulp survival rate.

CONCLUSIONS: Bidirectional splinting successfully managed cracked teeth with reversible pulpitis. Pain on percussion (mechanical allodynia) may be an important factor in deciding whether to attempt root canal treatment on symptomatic cracked teeth. A step-by-step approach with bidirectional crack splinting should be encouraged for a cracked tooth with a vital pulp without mechanical allodynia rather than preemptive root canal treatment.

PMID:34245604 | DOI:10.1111/iej.13597

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Nevin Manimala Statistics

COVID-19 in the Czech Republic 2020: probable transmission of the coronavirus SARS-CoV-2

Cent Eur J Public Health. 2021 Jun;29(2):159-161. doi: 10.21101/cejph.a6963.

ABSTRACT

OBJECTIVES: The aim of the study was to determine the probable places of coronavirus transmission in association with the work.

METHODS: The work analysed data from the Information System of Infectious Diseases managed by the Institute of Health Information and Statistics of the Czech Republic in the period March-December 2020.

RESULTS: 732,202 COVID-19 cases were officially confirmed, from them 64,587 (9%) represented work-related disease, 184,384 cases (25%) work-related contact, and 483,231 cases (66%) out-of-work contact. There were identified 13 occupations with the highest incidence of COVID-19 in the observed period (22,515 cases), in descending order nurse, paramedic, teacher, machinist, clerk, social worker, physician, worker/agency worker, craftsman, policeman, manager, food worker, and miner; 150 cases of COVID-19 were recognized as an occupational disease in 2020, from them 148 cases in the health and social care economic activity sector.

CONCLUSION: The available data show probable exposures to an infectious agent (without proof of specific contact with the source of the infection), of which at least one third are related to work, so different relevant anti-epidemic measures in the workplace have considerable practical importance for epidemic control.

PMID:34245557 | DOI:10.21101/cejph.a6963

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Nevin Manimala Statistics

A novel transcriptional risk score for risk prediction of complex human diseases

Genet Epidemiol. 2021 Jul 10. doi: 10.1002/gepi.22424. Online ahead of print.

ABSTRACT

Recently polygenetic risk score (PRS) has been successfully used in the risk prediction of complex human diseases. Many studies incorporated internal information, such as effect size distribution, or external information, such as linkage disequilibrium, functional annotation, and pleiotropy among multiple diseases, to optimize the performance of PRS. To leverage on multiomics datasets, we developed a novel flexible transcriptional risk score (TRS), in which messenger RNA expression levels were imputed and weighted for risk prediction. In simulation studies, we demonstrated that single-tissue TRS has greater prediction power than LDpred, especially when there is a large effect of gene expression on the phenotype. Multitissue TRS improves prediction accuracy when there are multiple tissues with independent contributions to disease risk. We applied our method to complex traits, including Crohn’s disease, type 2 diabetes, and so on. The single-tissue TRS method outperformed LDpred and AnnoPred across the tested traits. The performance of multitissue TRS is trait-dependent. Moreover, our method can easily incorporate information from epigenomic and proteomic data upon the availability of reference datasets.

PMID:34245595 | DOI:10.1002/gepi.22424

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Nevin Manimala Statistics

Identification of key genes in human urothelial cells corresponding to interstitial cystitis/bladder pain syndrome in a lipopolysaccharide-induced cystitis model

Neurourol Urodyn. 2021 Jul 10. doi: 10.1002/nau.24743. Online ahead of print.

ABSTRACT

AIMS: The cellular functions of bladder urothelial cells in interstitial cystitis/bladder pain syndrome (IC/BPS) have not been well revealed and understood. Thus, the study aims to identify key genes and significant pathways in urothelium corresponding to IC/BPS in a lipopolysaccharide (LPS)-induced cystitis model and provide novel clues related to diagnosis and treatment of IC/BPS.

METHODS: Human urothelial cells (HUCs) were incubated with LPS (50 μg/ml for 24 h). Microarray was applied to analyze the differentially expressed genes (DEGs) between HUCs under LPS treatment and the control group. DEGs in the two groups were identified and then used for enrichment analysis. Subsequently, protein-protein interaction (PPI) network based on DEGs was constructed. Lastly, the top five key genes were identified through the Cytoscape (version 3.7.2) using the “Clustering Coefficient” algorithm.

RESULTS: One hundred and seventy-one DEGs (96 upregulated genes and 75 downregulated genes) were identified between the LPS treatment and control group. The established PPI network was composed of 169 nodes and 678 edges. Moreover, C19orf33, TRIM31, MUC21, ELF3, and IFI27 were identified as hub genes in the PPI network. Subsequently, a statistically increased expression level of TRIM31 and ELF3 was validated by real-time quantitative-polymerase chain reaction and immunohistochemistry in bladder tissues from 20 patients with IC/BPS.

CONCLUSIONS: TRIM31 and ELF3 may be the two hub genes in urothelium corresponding to IC/BPS. More studies are warranted to further validate the findings. The identified marker genes may be useful targets for further studies to develop diagnostic tools and more effective therapies for a broader group of women with IC/PBS.

PMID:34245600 | DOI:10.1002/nau.24743

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Nevin Manimala Statistics

Mortality from external causes among 1-14 years old children in Serbia, 1997-2016

Cent Eur J Public Health. 2021 Jun;29(2):83-89. doi: 10.21101/cejph.a5922.

ABSTRACT

OBJECTIVES: Globally, child mortality from external causes is in decline, but it is still among the leading causes of child deaths. The aim of this first national study was to determine trends of mortality rates from external causes among children aged 1-14 years in Serbia.

METHODS: Mortality data were collected from the database of the Statistical Office of Serbia. Joinpoint analysis was used to assess the average annual percentage change (APC) and the corresponding 95% confidence interval (CI) in mortality from 1997 to 2016.

RESULTS: In the 1997-2016 period, there were 1,388 child deaths from external causes. They contributed to 29.4% of child mortality in total, from 34.8% in 1997 to 21.8% in 2016. Mortality rate was two times higher among boys (8.1 per 100,000) than girls (4.1 per 100,000). Transport accidents (37.6%), followed by drowning and submersion (18.2%), represented more than half of all deaths due to external causes. Since 1997, mortality rate showed a significant downward trend in boys by -5.4% (95% CI -6.8 to -3.9) yearly for unintentional injuries and significantly by -10% (95% CI -19.0 to 0.1) yearly for intentional injuries. Among girls, death rate for unintentional injuries decreased significantly by -7.1% (95% CI -9.0 to -5.1) yearly and decreased insignificantly for intentional injuries by -2.1% (95% CI -15.3 to 13.1) yearly.

CONCLUSIONS: The external causes of death, despite the substantial decline in mortality, are still present among children aged 1-14 years in Serbia. Therefore, implementation of nationwide programmes for prevention of external causes of death is urgent.

PMID:34245546 | DOI:10.21101/cejph.a5922

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Nevin Manimala Statistics

Evaluation of effectiveness of pathology reports in active surveillance of tuberculosis

Cent Eur J Public Health. 2021 Jun;29(2):96-101. doi: 10.21101/cejph.a6124.

ABSTRACT

OBJECTIVE: Despite advancing technology, national TB surveillance systems are still inadequate in terms of patient detection around the world. It was aimed to investigate suspicious cases detected by active surveillance method in pathology laboratories and to evaluate the effectiveness of this method in terms of finding new TB cases.

METHODS: This is a descriptive cross-sectional study. It was administrated in Samsun, Turkey, between January 2012-December 2017. Within the scope of active surveillance, pathology laboratories were regularly visited and reported cases with granulomatous inflammation were assessed. The obtained patient list was compared with the records of the Electronic Tuberculosis Management System (ETMS). Patients who were not included in these records were invited to the dispensary and evaluated for TB. They were also referred to the relevant hospitals for diagnosis if necessary. Frequency values and descriptive statistics were calculated using SPSS method.

RESULTS: It was found that 35.6% of 703 patients with the diagnosis of granulomatous inflammation were previously diagnosed, treated or currently undergoing treatment in the ETMS registry. As a result of the assessment of remaining 453 cases, 46 patients (10.1%) were newly diagnosed with TB. Newly diagnosed TB patients were reported, and their treatment started.

CONCLUSION: As a result, active surveillance method conducted in pathology laboratories are used to detect unknown or late reported TB cases and allows to start treatment without further delay.

PMID:34245548 | DOI:10.21101/cejph.a6124

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Nevin Manimala Statistics

Evaluation of estimated direct health expenses on tobacco- and alcohol-related diseases in context of excise taxes revenues in the Czech Republic

Cent Eur J Public Health. 2021 Jun;29(2):143-152. doi: 10.21101/cejph.a5538.

ABSTRACT

OBJECTIVES: This article deals with the comparison of excise tax revenues from alcoholic beverages and tobacco products with public spending that are spent on treating diseases occurring in consumers of these commodities.

METHODS: Based on available data, the study estimates direct public expenditures on the treatment of tobacco-related diseases and very frequent alcohol consumption-related diseases in the Czech Republic. These partial results are evaluated in the context of tax revenues from consumption of the mentioned commodities. The analysis works with the data from 1998-2017, which was obtained from the Ministry of Health of the Czech Republic, the National Institute of Public Health, the Customs Administration of the Czech Republic, the Ministry of Finance of the Czech Republic, and the Czech Statistical Office.

RESULTS: Medical treatment costs of smoking-related diseases were 18.35-48.19 billion CZK per year in the analysed period. These expenditures in the period 1998-2011 exceeded the annual revenues from the tax on tobacco products (in 2002 by 12.08 billion CZK). Since 2012, the balance has been positive in favour of public spending. Expenditures on the treatment of alcohol-related diseases amounted to 9.66-25.36 billion CZK per year in the given period, the expenditures, except the year 1998, exceeded the revenues from alcoholic beverages taxes (by 14.63 billion CZK in 2009).

CONCLUSIONS: The study shows that the excise tax revenues for tobacco products do not reach the level of healthcare spending for tobacco-related disease in the most of the analysed period, and this difference increases with the length of consumption, which can be interpreted in such a way that current excise tax revenues potentially mean public healthcare expenditures, which cumulatively exceed revenues from the relevant excise duties.

PMID:34245555 | DOI:10.21101/cejph.a5538

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Nevin Manimala Statistics

Quality improvement initiative to decrease extrauterine growth restriction in preterm neonates

Nutr Clin Pract. 2021 Jul 10. doi: 10.1002/ncp.10735. Online ahead of print.

ABSTRACT

BACKGROUND: Prevention of extrauterine growth restriction (EUGR) in preterm neonates is one of the biggest challenges to neonatologists. Lack of uniformity and inconsistency in nutrition practices are the most common causes. We started a quality improvement (QI) initiative with an intention to decrease the proportion of EUGR.

METHODS: We performed prospective nonrandomized QI from May 2018 to July 2019. Ninety-six neonates (born at <32 weeks and/or <1.2 kg) were compared with 111 historical controls. A continuous feedback loop was maintained, and changes were analyzed as plan-do-study-actcycle.

RESULTS: Although EUGR was lower after the intervention (93.7% vs 87.5%), this change was not statistically significant. However, other measures of in-hospital neonatal growth showed improvement, including median discharge weight percentile from 1% to 3% (P = .003). Median difference in the z-score for weight from birth to discharge also improved significantly from -1.84 to -1.65 (P = .04). Babies in the intervention group regained birth weight earlier (P = .005) and had better growth velocity (P = .0005). The feeding was started early (P < .0001), and these babies reached full feeds (P < .0001) earlier than the control cohort.

CONCLUSION: Although our QI initiative failed to achieve a significant reduction in EUGR, it did achieve a significant improvement in discharge weight percentile and difference in the z-score for weight at birth and during discharge from hospital. There was a significant improvement in growth velocity and an early regaining of birth weight. The implementation of written nutrition practice guidelines facilitated improved outcomes.

PMID:34245467 | DOI:10.1002/ncp.10735