Tag: pubmed

Rev Assoc Med Bras (1992). 2021 Sep;67(9):1246-1250. doi: 10.1590/1806-9282.20210156.

ABSTRACT

OBJECTIVE: The objective of this study was to compare the interventions of percutaneous transluminal drug-coated balloon angioplasty (DCB PTA) and standard PTA in the treatment of patients with the below-the-knee peripheral artery disease (BTK PAD).

METHODS: Overall, 196 patients (113 males and 83 females; mean age: 63.56±11.94 years; 45-83 years) were treated with PTA for BTK PAD between June 2014 and March 2019.

RESULT: Standard PTA (group 1; 96 patients) and DCB PTA (group 2; 100 patients) results were analyzed and compared retrospectively. No statistically significant difference was found between the mean ages of group 1 and 2 patients (p=0.371, p>0.05). Demographic and clinical data were compared and no any statistically significant differences was found between the two groups. Comparing in terms of the iliac lesion, there was no statistically significant difference between the two groups. However, a statistically significant difference was found between the two groups in terms of frequency of popliteal lesions (p=0.001; p<0.05). There was not a statistically significant difference between the two groups in terms of other lesions. In addition, limb salvage rates were 82.0% (18 amputations) and 65.6% (33 amputations) in the drug-release balloon group and the naked balloon group, at the end of 1 year, respectively. No distal embolism, limb-threatening ischemia, and mortality were observed in any patients.

CONCLUSIONS: Based on this study, patients in the DCB group had significantly higher rates of primary patency as compared with the other patients.

PMID:34816915 | DOI:10.1590/1806-9282.20210156

Braz Oral Res. 2021 Nov 19;35:e114. doi: 10.1590/1807-3107bor-2021.vol35.0114. eCollection 2021.

ABSTRACT

Dentifrices containing different active agents may be helpful to allow rehardening and to increase the resistance of the eroded surface to further acids or mechanical impacts. This study aimed to compare the effects of conventional (sodium fluoride [NaF]) and stannous fluoride (SnF2)-containing dentifrices on reducing erosive tooth wear (ETW). The PubMed/MEDLINE, Scopus, LILACS, BBO, EMBASE, TRIP electronic databases, and grey literature were searched until January 2021 to retrieve relevant in vitro and in situ studies related to research question. There were no restrictions on publication year or language. Two authors independently selected the studies, extracted the data, and assessed the risk of bias. ETW data were pooled to calculate and compare both dentifrices (overall analysis) and in vitro and in situ studies separately (subgroup analysis). Statistical analyses were performed using RevMan5.3 with a random effects model. Of 820 potentially eligible studies, 101 were selected for full-text analysis, and 8 were included in the systematic review and meta-analysis. There was a significant difference between SnF2-containing dentifrices and NaF dentifrices only for in vitro studies (p=0.04), showing a higher effect of the SnF2-containing dentifrices against the erosion/abrasion (effect size: -6.80 95%CI: -13.42; -0.19). Most in vitro and in situ studies had high and low risk of bias, respectively. In vitro literature suggests that the ETW reduction is greater when using SnF2-containing dentifrices instead NaF-containing dentifrices. However, the evidence level is insufficient for definitive conclusions. Clinical trials are necessary for a better understanding of the effect of these compounds on ETW.

PMID:34816902 | DOI:10.1590/1807-3107bor-2021.vol35.0114

Braz Oral Res. 2021 Nov 19;35:e117. doi: 10.1590/1807-3107bor-2021.vol35.0117. eCollection 2021.

ABSTRACT

This study evaluated by the efficacy of rotary and reciprocating systems to remove filling material by micro-CT. Sixty human canines were instrumented up to F3 by ProTaper Universal system and filled with AH Plus/ gutta-percha. Specimens were submitted to 1,200 thermal cycles, scanned by microCT SkyScan 1176 and randomly distributed in groups according to the filling material removal protocol (n = 10): ProTaper Universal, ProTaper Universal/xylol, ProTaper Next, ProTaper Next/xylol, Reciproc and Reciproc/xylol. After filling removal, specimens were analyzed by microCT to separately verify the presence of gutta-percha and sealer remnants. The data (mm3) were analyzed by two way ANOVA and Tukey´s test (5%). For the remaining gutta-percha, the use of xylol provided the highest values for Reciproc (7.60 ± 0.73), which was statistically different from the other groups (p < 0.05) that presented lower values and were statistically similar to each other (p > 0.05). For the remaining sealer, xylol provided the highest values (21.25 ± 6.94) different (p < 0.05) from the use of instruments alone (11.47 ± 9.45). ProTaper Next presented the lowest values (8.16 ± 1.37) for the remaining sealer, different (p < 0.05) from that of Reciproc (24.67 ± 6.32). The qualitative analysis revealed that all groups presented some remaining root filling material, with the highest volumes presented by Reciproc and Reciproc/xylol. In conclusion the rotary systems provided greater removal of filling material regardless of the use of xylol. The use of xylol negatively interfered with the action of the reciprocating system in the removal of the gutta-percha and sealer.

PMID:34816905 | DOI:10.1590/1807-3107bor-2021.vol35.0117

Braz Oral Res. 2021 Nov 19;35:e111. doi: 10.1590/1807-3107bor-2021.vol35.0111. eCollection 2021.

ABSTRACT

The aim of this study was to assess the factors associated with dental pain in adolescents from the state of Minas Gerais, Brazil. Individual data on adolescents aged 15 to 19 years were collected from the SB Minas survey secondary database. Dental pain over the past 6 months, assessed by a questionnaire, was used as the dependent variable. Sex, income, skin color, prevalence of untreated dental caries, periodontal health, dental treatment needs, and time of last dental appointment were analyzed as individual covariates. Allocation factor, Human Development Index (HDI), Gini coefficient, illiteracy rate, unemployment, 50% and 25% of the Brazilian monthly minimum wage, primary healthcare coverage, oral health team coverage, access to individual healthcare, and supervised toothbrushing average rate were the analyzed contextual variables. A multilevel analysis was conducted for the individual and contextual variables. Statistical analyses used hierarchical linear and nonlinear modeling to infer an association between the different levels. Male adolescents had a lower prevalence of dental pain (OR = 0.53; 95%CI = 0.37-0.75). There was an association between dental pain and low income (OR = 1.58; 95%CI = 1.07-2.33), prevalence of untreated dental caries (OR = 1.25; 95%CI = 1.11-1.40), periodontal health (OR = 1.80; 95%CI = 1.04-3.09), and dental treatment needs (OR = 6.93; 95%CI = 3.96-12.14). Sociodemographic and clinical factors at the individual level were associated with the outcome but not with contextual variables. These findings reinforce the need to address these factors for effective community health actions.

PMID:34816899 | DOI:10.1590/1807-3107bor-2021.vol35.0111

Braz Oral Res. 2021 Nov 19;35:e112. doi: 10.1590/1807-3107bor-2021.vol35.0112. eCollection 2021.

ABSTRACT

The present study aimed to evaluate the frequency of immediate care seeking after traumatic dental injury (TDI) in primary dentition and its association with the children’s characteristics, socioeconomic status, and TDI characteristics. This was a cross-sectional study with dental records of children aged 9 months to 6 years who attended a reference center in TDI in primary dentition between 2007 and 2018. Immediate care seeking after TDI, child’s characteristics, sociodemographic conditions and TDI characteristics were collected. Descriptive statistics and Poisson regression analysis with robust variance were performed (p < 0.05; 95%CI). Among the 493 dental records, 61.1% (n = 301) were of males and 50.5% (n = 249) were from children aged 2 years or less. More than one third of the sample (36.9%; n = 182) sought immediate care after TDI. Among the types of TDI, the prevalence of soft tissue injuries was 59.0% (n = 291), while 51.7% (n = 255) were hard tissue injuries and 54.0% (n = 266) were supporting tissue injuries. Immediate care seeking after TDI was higher in children who needed suture (PR: 1.39; 95%CI: 1.01-1.92. p = 0.039), had luxation (lateral, intrusion, or extrusion) (PR: 2.36; 95%CI: 1.36-4.08. p = 0.002) or avulsion (PR: 2.18; 95%CI: 1.28-3.70. p = 0.004). The need for suture, luxation (lateral, intrusion and extrusion), and avulsion were determinant factors for the immediate care seeking after TDI, regardless of the child’s characteristics and socioeconomic status.

PMID:34816900 | DOI:10.1590/1807-3107bor-2021.vol35.0112

Braz Oral Res. 2021 Nov 19;35:e107. doi: 10.1590/1807-3107bor-2021.vol35.0107. eCollection 2021.

ABSTRACT

This study aimed to evaluate the clinical and sociodemographic factors associated with the oral health-related quality of life (OHRQoL) of homeless persons. A cross-sectional study was conducted, with participants (n = 176) attending a Specialized Reference Center for the Homeless Population in Teresina, Brazil. Dental caries (DMFT index, WHO criteria), periodontal disease (CPI index), and the consequences of untreated caries (PUFA index) were measured by a single calibrated examiner (Kappa ≥0.83). Sociodemographic, oral health, and OHRQoL (OHIP-14) data were obtained through interviews. Data analysis included descriptive statistics and Poisson regression, with a significance level of 5%. Most of the participants were male (86.4%) and from the age group of 30 to 43 years (52.2%). Mean DMFT was 11 (SD ± 6.9) and mean total PUFA score was 1.2 (SD ± 2.2). Most of the participants (88.6%) had dental calculus and 8.5% and 1.7% of the sample had gingival bleeding and periodontal pocket > 3.5mm, respectively. The highest prevalence of negative impact in the OHRQoL was associated with females (1.4 (95%CI 1.1-1.7)), low educational level (2.0 (95%CI 1.3-3.0)), caries (1.6 (95%CI 1.1-2.6)), fistulas (1.9 (95%CI 1.3-3.1)), gingival bleeding (1.7 (95%CI 1.1- 2.7)), dental calculus (1.8 (95% CI 1.3-2.5)), periodontal pockets > 3 mm (1.5 (95%CI 1.1-2.0)), and need for extraction (2.3 (95%CI 1.1-5.0)). In conclusion, the negative impact on the OHRQoL of homeless persons was associated with low educational level, presence of decayed teeth, gingival bleeding, and dental calculus.

PMID:34816895 | DOI:10.1590/1807-3107bor-2021.vol35.0107

Otol Neurotol. 2021 Nov 23. doi: 10.1097/MAO.0000000000003435. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the clinical outcomes of pediatric patients implanted a novel 4.5 mm wide laser ablated titanium bone anchored implant system and to evaluate the implant stability over the first 12-month period.

STUDY DESIGN: A prospective, single-subject, repeated measure, cohort study. Participants served as their own controls.

SETTING: Community and tertiary referral hospital pediatric assessment center.

PATIENTS: A total of 115 consecutive pediatric patients aged 4 to 15 years were implanted with 176 laser ablated titanium bone anchored implants from January 2016 to January 2019.

MAIN OUTCOME MEASURE: Clinical outcomes, implant failure rates, and post implantation implant stability quotient (ISQ) scores were studied over the first 12-month period. Data were analyzed for statistical significance through mixed effect modeling, with the significance level p = 0.01.

RESULTS: A median 12-month survival of 96.6% was observed. Six implants (3.5%) were lost in total, one of these (0.6%) was lost due to trauma. Adverse skin reactions (Holgers grade 2-4) were observed in 4.4% of all postoperative visits, occurring in 22 individuals (19.1%). Neither the ISQ high (ISQH) nor ISQ low (ISQL) values increased significantly between the stage 1 and 2 surgeries. In contrast, the ISQ results, irrespective of abutment size, demonstrated an increasing trend from 49.1 to 57 over the 12 months review period. A statistically significant change was only demonstrated from the 3 months follow up onwards.

CONCLUSION: The use of 4.5 mm wide laser-ablated titanium bone anchored hearing implants resulted in superior survival rates and excellent clinical outcomes compared with previous implant systems.

PMID:34816808 | DOI:10.1097/MAO.0000000000003435

Otol Neurotol. 2021 Nov 23. doi: 10.1097/MAO.0000000000003418. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the audiological and subjective benefit from hearing rehabilitation with an active bone conduction implant in subjects with single-sided sensorineural deafness (SSD).

STUDY DESIGN: Prospective, multicenter, single-subject repeated measures.

SETTING: Tertiary referral center, five clinics in Germany and Switzerland.

PATIENTS: Seventeen subjects aged 18 years and older with severe to profound unilateral sensorineural hearing loss and contralateral normal hearing were followed up for 24 months.

INTERVENTION: Active bone conduction implant.

MAIN OUTCOME MEASURES: Speech understanding in noise was assessed in three situations: with signal from front, deaf, or normal hearing side (with noise from front in all set-ups). Subjective benefit was evaluated using the Speech, Spatial, and Qualities of Hearing (SSQ-B) and Bern Benefit in Single-Sided Deafness (BBSS) questionnaire.

RESULTS: When the signal was coming from the deaf side the mean improvement of the speech reception threshold in noise ranged from 1.5 up to 2.2 dB with the device and was statistically and clinically significant at all tested timepoints. No significant difference between the aided and unaided situation was found when signal and noise were coming from the front. With the signal from the normal hearing side no clinically significant difference, that is, greater than 1 dB between the aided and unaided situation was found. The SSQ-B and BBSS questionnaire showed an overall improvement with no significant difference between time points.

CONCLUSIONS: The study demonstrates long-term efficacy and benefit of the device in adults with SSD. Patients reported substantial and persistent subjective benefit from the active bone conduction implant.

PMID:34816809 | DOI:10.1097/MAO.0000000000003418

Technol Cancer Res Treat. 2021 Jan-Dec;20:15330338211062323. doi: 10.1177/15330338211062323.

ABSTRACT

Objectives: To compare the efficacy of complete transurethral resection of bladder tumor combined with postoperative chemoradiotherapy and radical cystectomy (RC) in the treatment of muscle-invasive bladder cancer (MIBC). Methods: This is a single-center, retrospective study. Clinical data of 125 patients with MIBC admitted to the First Affiliated Hospital of Soochow University from December 2012 to December 2015 were retrospectively analyzed, in which 79 patients (tri-modality therapy [TMT] group) received TMT bladder-sparing treatment, and 41 patients (RC group) received RC. The differences of probabilities for 1-year, 2-year, 5-year, and comprehensive overall survival (OS), progress-free survival (PFS) between 2 groups were calculated using Kaplan-Meier product limited estimates. Univariate and multivariate analyses were performed to detect potential risk factors for OS and PFS. Results: There was no statistical difference between the TMT group and RC group in the 1-year, 2-year, 5-year, comprehensive OS rate, and PFS rate. And survival analysis found no significant difference in OS and PFS between the 2 groups. Univariate analysis showed that age, TNM staging, and prognostic nutritional index (PNI) were associated with OS, while PNI was connected to tumor recurrence. Multiple linear regression analysis indicated that TNM staging and PNI were independent risk factors for OS. Conclusions: TMT can be used as an alternative to RC for MIBC patients under the premise of strict control of indications, rigorous postoperative follow-up, and timely salvage cystectomy. PNI was negatively correlated with OS and PFS, while TNM staging was positively correlated with OS.

PMID:34816789 | DOI:10.1177/15330338211062323

J Healthc Manag. 2021 Nov 23. doi: 10.1097/JHM-D-21-00092. Online ahead of print.

ABSTRACT

GOAL: As strategies emerge to off-load hospital systems and prevent readmissions amid the COVID-19 pandemic, pragmatic assessments of readmission risk become increasingly important. The simplified HOSPITAL score is an extensively validated tool that predicts 30-day potentially avoidable readmission (PAR). Scores of 0 to 4 predict a 30-day PAR risk of 6.4%, while scores ≥ 5 predict a 30-day PAR risk of 17.3%. Its role in patients with COVID-19 is unknown. Our goal was to assess the simplified HOSPITAL score’s accuracy in patients with COVID-19 and explore outcomes related to a hospital-at-home program.

METHODS: Patients discharged following an admission for clinically symptomatic COVID-19 from two hospitals belonging to the same healthcare system in the Midwest were included. Those who died, discharged to hospice or an acute care hospital, whose length of stay was < 1 day, or who discharged against medical advice were excluded. The simplified HOSPITAL score was tabulated for included patients to predict their 30-day PAR risk. The Brier score was calculated to compare the observed rates of 30-day readmission with rates predicted by the simplified HOSPITAL score. Prediction models with a Brier score <.25 are considered useful.

PRINCIPAL FINDINGS: Among 612 patients, the overall 30-day PAR rate was 10.1%. Most patients (n = 522 [85.3%]) had simplified HOSPITAL scores of 0 to 4, and 41 (7.8%) of these patients were readmitted. Among the 90 patients (14.7%) with scores ≥5, 21 (23.3%) were readmitted. The Brier score was 0.088, indicating very good accuracy between the predicted readmission risk and observed readmissions. In patients with scores 0 to 4, readmissions were highest in those discharged to acute or subacute rehabilitation (10.4% [8/77]), intermediate in those discharged home (8.1% [32/394]), and lowest in those discharged to hospital at home (1.9% [1/51]). However, these differences did not reach statistical significance.

APPLICATION TO PRACTICE: The simplified HOSPITAL score was accurate in patients with COVID-19 and can be used to direct resources toward those predicted to be at increased risk for readmission and to assess outcomes from readmission reduction strategies. Hospitals at home may be a promising strategy to decrease readmissions in patients with COVID-19.

PMID:34816806 | DOI:10.1097/JHM-D-21-00092