Tag: pubmed

Aust Endod J. 2022 Mar 1. doi: 10.1111/aej.12611. Online ahead of print.

ABSTRACT

The aim of this study was to evaluate the effect of calcium hydroxide (CH) and niobium pentoxide (NP) pretreatment on pH, dentin microhardness and sealing of Mineral Trioxide Aggregate (MTA; Angelus). The pH of CH, NP and CH-NP (3:1) was evaluated in neutral and acidic simulated tissue fluid over 28 days. The Vickers microhardness was measured in forty 4 mm coronal root slices filled with pretreatment materials stored in medium for 1, 7, 28 days. Forty 10 mm roots were packed with pretreatment materials, irrigated after 24 h, then a 3 mm MTA plug was placed. Sealing ability was evaluated after 7 days using fluid filtration method. Statistics was performed using ANOVA and post hoc Tukey HSD tests. Addition of NP to CH maintained the alkalinity of CH, increased the microhardness of root dentin and reduced the microleakage. CH-NP can be effectively used as a pretreatment medicament in root canals requiring placement of MTA under acidic conditions.

PMID:35229927 | DOI:10.1111/aej.12611

J Clin Pharm Ther. 2022 Mar 1. doi: 10.1111/jcpt.13631. Online ahead of print.

ABSTRACT

WHAT IS KNOWN AND OBJECTIVE: Patients with tuberous sclerosis complex (TSC) demonstrate disrupted lipid homeostasis before and during treatment with mammalian target of rapamycin (mTOR) inhibitor. However, few previous reports focused on if the serum lipid status at baseline would influence lipid metabolic side-effects of mTOR inhibitors for TSC associated renal angiomyolipomas (TSC-AML). The present study was designed to evaluate the predictive function of serum lipid status at baseline for hyperlipidaemia by mTOR inhibitor treatment in TSC-AML patients.

METHODS: The clinical data of TSC-AML patients who took mTOR inhibitors in Department of Urology of Peking Union Medical College Hospital (PUMCH) from 1 January 2014 to 1 January 2021, were retrospectively analysed. The record of lipid parameters at baseline and the highest levels of total cholesterol (TC) and triglyceride (TG) after treatment at least ≥3 months were collected. The correlation of serum lipid parameters at baseline with incidence of hyperlipidaemia during mTOR inhibitor treatment was analysed. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the ability of the serum lipid parameters in predicting hyperlipidaemia.

RESULTS AND DISCUSSION: 19 patients experienced hyperlipidaemia and 13 patients still had normal TC and TG levels during mTOR inhibitor treatment. The levels of high-density lipoprotein cholesterol (HDL-C) (0.98 ± 0.30 mmol/L vs. 1.23 ± 0.31 mmol/L, p = 0.030), low-density lipoprotein cholesterol (LDL-C) (2.47 ± 0.69 mmol/L vs. 1.95 ± 0.53 mmol/L, p = 0.029) and apolipoprotein B (ApoB) (0.82 ± 0.21 g/L vs. 0.65 ± 0.16 g/L, p = 0.019) are higher in the patients who experienced hyperlipidaemia during mTOR inhibition therapy. TC, TG, LDL-C, ApoB and high-sensitivity C-reactive protein (hsCRP) at baseline had positive correlation with TC after treatment; ApoB at baseline had positive correlation, while HDL-C and free fat acid (FFA) at baseline had negative correlation with TG after treatment. Therefore, ApoB concentration at baseline has statistically significant correlation with both TC (p < 0.001) and TG (p = 0.012) levels after mTOR inhibitor treatment. ROC curve and AUC revealed that ApoB with a cut-off value of 0.640g/L may be the best parameter for predicting hyperlipidaemia during mTOR inhibitor treatment in TSC-AML patients. The incidence rates of hyperlipidaemia were 27.3% and 76.2% among the patients with ApoB level ≤0.640 g/L and >0.640 g/L respectively.

WHAT IS NEW AND CONCLUSION: Some baseline serum lipid parameters could be used for predicting incidence of hyperlipidaemia during mTOR inhibition therapy in TSC-AML patients, and ApoB with 0.640 g/L as a cut-off value may be a potentially optimal indicator, which could help for diagnosis and treatment decision-making.

PMID:35229896 | DOI:10.1111/jcpt.13631

Community Dent Oral Epidemiol. 2022 Mar 1. doi: 10.1111/cdoe.12735. Online ahead of print.

ABSTRACT

OBJECTIVE: The International Caries Classification and Management System (ICCMS™), a comprehensive, evidence-informed, best clinical practice system, comprises a 4D cycle: 1D-Determine risk; 2D-Detect and assess lesions; 3D-Decide on a personalized care plan; and 4D-Do preventive and tooth-preserving care. The aim of this study was to establish how Colombian dental practitioners, educators and students diagnose and manage caries risk and caries lesions using the COM-B model and the ICCMS™ system.

METHODS: A total of 1094 participants (practitioners: n = 277; educators: n = 212; students: n = 605) completed a previously validated 79-item questionnaire which explores, based on the COM-B model, the practitioners’ self-reported caries diagnosis and management behaviours. Descriptive statistics, Welch’s ANOVAs and multiple linear regressions were computed.

RESULTS: All groups generally performed the behaviours within the 4-D categories ‘Most of the time’ to ‘Always’ (students: 4.06 ± 0.95; educators: 3.94 ± 0.98; practitioners: 3.86 ± 1.01). The most frequently performed diagnosis behaviours (1D/2D) were for practitioners assessing initial/moderate lesions (4.09 ± 1.01) and for educators and students cleaning teeth before lesion assessment (4.41 ± 0.80 and 4.38 ± 0.77 respectively). The least frequently performed decision/management (3D/4D) behaviour was non-operative care for moderate-caries lesions (when applicable) (practitioners: 2.64 ± 1.23; educators: 2.68 ± 1.17; students: 3.22 ± 1.41). Opportunity (Resources and Relevance) was the best COM-B predictor for diagnostic behaviours, whereas capability and opportunity (Relevance) were the strongest predictors for management behaviours.

CONCLUSION: Colombian practitioners, educators and students diagnose and manage caries risk and caries lesions implementing best practice with a high to very high frequency.

PMID:35229897 | DOI:10.1111/cdoe.12735

J Am Geriatr Soc. 2022 Mar 1. doi: 10.1111/jgs.17708. Online ahead of print.

ABSTRACT

BACKGROUND: Few studies of social isolation, loneliness and associations with all-cause mortality in older adults have been conducted in non-Western countries. The aim of this study was to conduct such an analysis in a nationally representative sample of Chinese older adults.

METHODS: This study used eight waves of data from the Chinese Longitudinal Healthy Longevity Survey from 1998 to 2018 and focused on participants aged ≥60 years. A total of 21,570 people died (61.2%) over a median follow-up of 4.8 years. Social isolation, loneliness, demographic, health and lifestyle factors were measured at baseline. The primary outcome was all-cause mortality. Cox proportional hazard regression models were used to examine the associations of isolation and loneliness with all-cause mortality.

RESULTS: This study included 35,254 participants with mean age of 86.63 ± 11.39 years. Social isolation was significantly associated with an increased mortality (adjusted HR 1.22; 95% CI 1.18-1.25; p < 0.01). The association of loneliness with mortality was nonsignificant after adjustment for health indicators and low psychological well-being (HR 1.01; 95% CI 0.98-1.04; p = 0.69). However, when stratified by age, there was a significant association of loneliness with mortality among participants aged <80 years (HR 1.15; 95% CI 1.05-1.26; p < 0.01).

CONCLUSIONS: Social isolation was associated with an increased all-cause mortality among the older Chinese adults. However, loneliness was associated with an increased mortality only among younger participants. Public health interventions aimed at increasing social connectedness may potentially reduce excess mortality among older adults.

PMID:35229887 | DOI:10.1111/jgs.17708

Int J Epidemiol. 2022 Mar 1:dyac023. doi: 10.1093/ije/dyac023. Online ahead of print.

ABSTRACT

BACKGROUND: The association between body mass index (BMI) and oesophageal cancer (OC) has been consistently negative among Asians, whereas different associations based on histological OC subtypes have been observed in Europeans and North Americans. We examined the association between BMI and OC mortality in the Asia Cohort Consortium.

METHODS: We performed a pooled analysis to evaluate the association between BMI and OC mortality among 842 630 Asians from 18 cohort studies. Cox regression models were used to estimate hazard ratios (HRs) and 95% CIs.

RESULTS: A wide J-shaped association between BMI and overall OC mortality was observed. The OC mortality risk was increased for underweight (BMI <18.5 kg/m2: HR = 2.20, 95% CI 1.80-2.70) and extreme obesity (BMI ≥35 kg/m2: HR = 4.38, 95% CI 2.25-8.52) relative to the reference BMI (23-25 kg/m2). This association pattern was confirmed by several alternative analyses based on OC incidence and meta-analysis. A similar wide J-shaped association was observed in oesophageal squamous cell carcinoma (OSCC). Smoking and alcohol synergistically increased the OC mortality risk in underweight participants (HR = 6.96, 95% CI 4.54-10.67) relative to that in reference BMI participants not exposed to smoking and alcohol.

CONCLUSION: Extreme obesity and being underweight were associated with an OC mortality risk among Asians. OC mortality and BMI formed a wide J-shaped association mirrored by OSCC mortality. Although the effect of BMI on OSCC and oesophageal adenocarcinoma mortality can be different in Asians, further research based on a large case-control study is recommended.

PMID:35229874 | DOI:10.1093/ije/dyac023

Medwave. 2021 Oct 26;21(9):e8481. doi: 10.5867/medwave.2021.09.2119.

ABSTRACT

OBJECTIVE: To determine the scientific production of doctoral graduates in Peru.

METHODS: We made a descriptive cross-sectional study with a quantitative analysis approach of the scientific production of doctoral graduates in all areas of science registered in the National Council of Science, Technology and Technological Innovation of Peru.

RESULTS: We analyzed the scientific production of 942 doctoral graduates with a median time since the graduation of 84 months (interquartile range: 36 to 132). In total, 532 (56.48%) had published an article in their lifetime. The median of published articles was four (interquartile range: 2 to 12), and the median H-index of the doctoral graduates who had published was two (interquartile range: 1 to 5). We found that the number of publications and H-index was statistically different according to the doctorate area of science (p < 0.05 for both). Natural Sciences (69.13%), Engineering (67.47%), and Health Sciences (67.08%) had the highest proportion of doctoral graduates with at least one publication. Regarding gender and university of origin (foreign or Peruvian), it was found a difference concerning the number of articles published and the H-index (p < 0.05 for both) being that male and doctoral graduates with a foreign doctoral degree had higher scientific production.

CONCLUSIONS: Only six out of 10 Peruvian doctoral graduates have published at some point in their life. The areas of science with the highest production by doctoral graduates were Natural Sciences, Engineering, and Health Sciences. There is higher scientific production in males and graduates from a foreign university.

PMID:35229830 | DOI:10.5867/medwave.2021.09.2119

Int J Epidemiol. 2022 Mar 1:dyac018. doi: 10.1093/ije/dyac018. Online ahead of print.

NO ABSTRACT

PMID:35229872 | DOI:10.1093/ije/dyac018

Neurosurgery. 2022 Mar 3. doi: 10.1227/NEU.0000000000001869. Online ahead of print.

ABSTRACT

BACKGROUND: Local management for vestibular schwannoma (VS) is associated with excellent local control with focus on preserving long-term serviceable hearing. Fractionated proton radiation therapy (FPRT) may be associated with greater hearing preservation because of unique dosimetric properties of proton radiotherapy.

OBJECTIVE: To investigate hearing preservation rates of FPRT in adults with VS and secondarily assess local control and treatment-related toxicity.

METHODS: A prospective, single-arm, phase 2 clinical trial was conducted of patients with VS from 2010 to 2019. All patients had serviceable hearing at baseline and received FPRT to a total dose of 50.4 to 54 Gy relative biological effectiveness (RBE) over 28 to 30 fractions. Serviceable hearing preservation was defined as a Gardner-Robertson score of 1 to 2, measured by a pure tone average (PTA) of ≤50 dB and a word recognition score (WRS) of ≥50%.

RESULTS: Twenty patients had a median follow-up of 4.0 years (range 1.0-5.0 years). Local control at 4 years was 100%. Serviceable hearing preservation at 1 year was 53% (95% CI 29%-76%), and primary end point was not yet reached. Median PTA and median WRS both worsened 1 year after FPRT (P < .0001). WRS plateaued after 6 months, whereas PTA continued to worsen up to 1 year after FPRT. Median cochlea D90 was lower in patients with serviceable hearing at 1 year (40.6 Gy [RBE] vs 46.9 Gy [RBE]), trending toward Wilcoxon rank-sum test statistical significance (P = .0863). Treatment was well-tolerated, with one grade 1 cranial nerve V dysfunction and no grade 2+ cranial nerve dysfunction.

CONCLUSION: FPRT for VS did not meet the goal of serviceable hearing preservation. Higher cochlea doses trended to worsening hearing preservation, suggesting that dose to cochlea correlates with hearing preservation independent of treatment modality.

PMID:35229827 | DOI:10.1227/NEU.0000000000001869

Saudi J Kidney Dis Transpl. 2021 Jul-Aug;32(4):1073-1088. doi: 10.4103/1319-2442.338281.

ABSTRACT

There is a paucity of data on epidemiology along with an incomplete registry of end-stage kidney disease (ESKD), nephrologist workforce, and variability among the countries of Gulf Cooperation Council (GCC). The study is an observation, descriptive study which aimed to describe current ESKD burden, nephrologist density, and kidney care infrastructure in GCC. Responses to a questionnaire-based survey obtained from representatives of the Nephrology Societies of GCC countries were analyzed. The categorical variables were compared using Chi-square test. A P = 5% was considered as significant. The mean prevalence of ESKD per million populations (pmp) was 551, highest in Oman (1000/pmp), least in Qatar (347/pmp). Predominant etiology in GCC was diabetes mellitus (DM) and hypertension (HTN) (100%, each), followed by chronic glomerulonephritis (66.7%). A transplant registry was maintained by all GCC countries. Hemodialysis (HD) (67.2%) was the most opted modality of kidney replacement therapy (KRT), followed by kidney transplantation (22%) and peritoneal dialysis (9.6%); 1.0% of patients opted for conservative management. Unplanned initiation of HD was three times more common. The access distribution among incident and prevalent HD patients respectively was (i) nontunneled central catheter (nTCC) (58.7 ± 36.6 vs. 1.5 ± 1.5), (ii) tunneled central catheter (23.5 ± 29.9 vs. 33.6 ± 10.0), and (iii) arteriovenous fistula (17.3± 14.4 vs. 57.8 ± 11.86). Death and transplantation were the reasons for dropout from HD. GCC has adequate kidney care infrastructure. There are 1686 nephrologists [range: Bahrain 9, Kingdom of Saudi Arabia (KSA) 1279]. Qatar, KSA, and Kuwait provide training in kidney biopsy; all countries except Bahrain have formal training programs for nTCC placement. ESKD prevalence is high, DM, HTN; glome-rulonephritis (GN) is the most common causes. The need for KRT is expected to rise in GCC. HD is the predominant KRT modality with a high prevalence of dialysis catheters as vascular access.

PMID:35229807 | DOI:10.4103/1319-2442.338281

Saudi J Kidney Dis Transpl. 2021 Jul-Aug;32(4):1111-1117. doi: 10.4103/1319-2442.338284.

ABSTRACT

Acute kidney injury (AKI) in postpartum is a rare, but deadly complication of pregnancy. It has great impact on maternal and fetal outcomes. The study aimed to study the incidence and etiological profile with outcomes of postpartum AKI patients and to see whether need for hemodialysis (HD) alters the outcome. This is a retrospective observation study done in a tertiary care center at the Department of Nephrology, Ramkrishnan Care Hospital, Raipur, Chhattisgarh, India. All postpartum women suffering from AKI between May 2011 and May 2017 were included in this study. Demographic, clinical, and laboratory data of the patients were included. Outcome variables including maternal and fetal mortality with renal outcome during discharge and follow-up for three months were noted. Patients were divided into two groups: Group 1 underwent HD and Group 2 was managed conservatively. Statistical analysis was done on the Statistical Package for the Social Sciences software version 17.0. Categorical data were expressed as ratio and proportions, while continuous data were expressed as mean plus standard deviation (SD). Quantitative data were analyzed by percentage, mean, SD, and t-test. Qualitative data were analyzed by Chi-square test. The incidence of postpartum AKI was 3.26% and the mean age of the study population was 27.3 ± 4.77 years. Multifactorial (53.27%) etiology was the most cause of postpartum AKI, and the second was puerperal sepsis (32.7%). Seventy-three (68.22%) patients had undergone HD. Four (4.47%) patients require lifelong HD. Renal biopsy was done in seven patients, three had cortical necrosis among fetal outcomes, total live births were 92 (85.98%), and 15 (14.01%) died in the neonatal period. There was no statistically significant difference between Group 1 and Group 2 in etiological profile (P >0.55), maternal mortality (P >0.66), and renal outcome (P >0.11). Postpartum AKI was associated with poor maternal outcome and renal recovery. Maternal mortality and renal recovery were not affected by need of dialysis in our patients. Proper antenatal care and peripartum monitoring with practicing aseptic precaution will definitely help in reduction of postpartum AKI and maternal mortality in our state.

PMID:35229810 | DOI:10.4103/1319-2442.338284