Tag: pubmed

Int Dent J. 2021 Jul 5:S0020-6539(21)00099-X. doi: 10.1016/j.identj.2021.05.003. Online ahead of print.

ABSTRACT

BACKGROUND: Some older people stop visiting the dentist when they get older. This study aims to identify the characteristics and oral health status of older people who do visit community dental practices.

METHODS: In this exploratory cross-sectional study, the oral health of Dutch community-dwelling older people was assessed. A random sample of general dental practitioners and older people who visit the dental practice was drawn. The dentists were asked to prospectively select one older patient and describe this patient using a specially developed registration form; the patient was requested to complete a questionnaire. Data were described for 3 distinct groups of older people. Statistical measures for distribution and dispersion were used to describe the oral health of community-dwelling older patients in relation to the age.

RESULTS: A total of 373 (40.4%) dentist registration forms and 372 (40.3%) patient questionnaires were returned. Data were available for 364 (39.4%) dentist-patient couples. Amongst the patients, 52.8% were female and most had a high socioeconomic status. About 65.7% had one or more problems related to general health, and 75.2% used medication. Regarding the overall oral health status, the average number of teeth was 20, 3.5% were edentulous. Oral health problems were more common in the older patient group (aged 75+), in whom frailty was also most common.

CONCLUSIONS: Older people who visit community dental practices are still relatively healthy, non-frail, and highly educated. Even in this group, there is a turning point in both general and oral health from the age of 75.

PMID:34238570 | DOI:10.1016/j.identj.2021.05.003

Dent Mater. 2021 Jul 5:S0109-5641(21)00190-1. doi: 10.1016/j.dental.2021.06.010. Online ahead of print.

ABSTRACT

OBJECTIVE: Healing of soft tissues and improvement of aesthetics have become major research objectives in implantology and renewed the interest for ceramics implants. The aim of this study was to evaluate the pre-clinical performance of screw-shaped sandblasted-etched implants processed from an innovative zirconia-based ceramic composite, in comparison to titanium.

METHODS: Twenty-four ceramic and twenty-four titanium screw-shaped sandblasted-etched dental implants were tested in a split-mouth design in six Beagle dogs. Surface topographies were investigated by confocal microscopy. Local tissue effects were evaluated at 4 and 13 weeks after implantation through histology. An ANOVA statistical analysis (5% risk; p < 0.05) was performed to compare peri-implant quantitative histomorphometric parameters on buccal and lingual sides, including Bone to Implant Contact (BIC) among test groups and time-periods.

RESULTS: Titanium and ceramic implants presented respectively moderate and minimal roughness. After 4 and 13 weeks, ceramic implants showed an inflammatory tissue response close to titanium implants. At both period of time there was no significant difference between the titanium and ceramic groups in terms of BIC values (mean ± SD) at the lingual or buccal sides or when combining buccal + lingual BIC values (respectively for titanium and ceramic, 68.4 ± 14.7 % and 75.0 ± 13.5 % at 4 weeks, and 92.0 ± 8.6 % and 86.1 ± 13.8 % at 13 weeks).

SIGNIFICANCE: Within the limits of the present study, it can be concluded that newly developed zirconia-based ceramic composite dental implants have similar biocompatibility and osseointegration to those observed in titanium implants. These pre-clinical results corroborate the potential for the use of these new zirconia-based ceramics in oral implantology.

PMID:34238605 | DOI:10.1016/j.dental.2021.06.010

Handb Clin Neurol. 2021;181:41-49. doi: 10.1016/B978-0-12-820683-6.00004-X.

ABSTRACT

Aneurysmal subarachnoid hemorrhage (aSAH) results from the rupture of an intracranial aneurysm and represents a highly debilitating and devastating disorder. The prevalence rate of neuroendocrine impairment in the acute phase is extremely variable, ranging from 3.8% to 92.3%, depending on the time point considered, the method/test utilized, the clinical severity at admission, and probably also ethnicity. Further studies are needed to clarify such a wide range in neuroendocrine dysfunction in patients with aSAH. The overall neuroendocrine impairment rate in chronic aSAH is in the range 47%-83.3% with specific neuroendocrine impairment varying from 2.5% to 83.3%. The overall pituitary deficiency rate tends to decrease over time after SAH, with recovery of most endocrine and some de novo dysfunctions being reported. Only one study has reported an increase of overall endocrine impairment in the chronic follow-up. Neuroendocrine dysfunction seems to have a high prevalence in aSAH patients, even though its exact impact is not precisely known and is based on contrasting findings. More high-quality studies and trials are necessary before informing guidelines and protocols recommending preventive endocrine screening and related treatment (hormone replacement therapy) on a routine basis. The usage of standardized testing and reporting procedures could significantly move the field forward.

PMID:34238475 | DOI:10.1016/B978-0-12-820683-6.00004-X

Neurologia (Engl Ed). 2021 Jul-Aug;36(6):433-439. doi: 10.1016/j.nrleng.2018.03.003. Epub 2020 Feb 7.

ABSTRACT

INTRODUCTION: Pain is highly prevalent in patients with multiple sclerosis (MS); it is chronic in 50% of cases and is classified as nociceptive, neuropathic, or mixed-type. Pain affects quality of life, sleep, and the activities of daily living. Electrotherapy is an interesting alternative or complementary treatment in the management of pain in MS, with new innovations constantly appearing.

MATERIAL AND METHODS: This study evaluates the effectiveness of treatment with monopolar dielectric transmission of pulsed electromagnetic fields (PEMF) for pain associated with MS. We performed a randomised, placebo-controlled clinical trial including 24 patients, who were assessed with the Brief Pain Inventory, the Multiple Sclerosis International Quality of Life questionnaire, the Beck Depression Inventory, and the Modified Fatigue Impact Scale.

RESULTS: Statistically significant improvements were observed in maximum and mean pain scores, as well as in the impact of pain on work, personal relationships, and sleep and rest. Not significant differences were found between the treatment and placebo groups.

CONCLUSIONS: Treatment with PEMF may be effective in reducing pain in patients with MS, although further research is necessary to confirm its effectiveness over placebo and to differentiate which type of pain may be more susceptible to this treatment.

PMID:34238526 | DOI:10.1016/j.nrleng.2018.03.003

J Prosthet Dent. 2021 Jul 5:S0022-3913(21)00266-3. doi: 10.1016/j.prosdent.2021.04.027. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Information regarding the rotational freedom of internal connection implants is sparse.

PURPOSE: The purpose of this in vitro study was to compare the rotational freedom of different internal conical and internal nonconical connections.

MATERIAL AND METHODS: Thirty implants, 30 straight manufactured standard abutments, and 30 standard abutment screws were obtained for each of the 5 implant systems tested. Three implant systems had indexed internal conical connections with different antirotational geometries: hexagon (Naturall+), cam-groove (ID CAM M), and octagon (Bone Level). Two implant systems had internal nonconical connections with hexagonal antirotational geometry (Tapered Screw-Vent and Seven). The implants were mounted in a steel plate, and a metal reference arm was attached to the abutment. Before tightening the standard abutment screw, a modified torque wrench was used to rotate the abutment clockwise until reaching the clockwise rotational endpoint. This modified torque wrench was connected to the abutment’s outer surface. It allowed free access to the standard abutment screw for a second torque wrench, specific to each implant system. The modified torque wrench applied a controlled torque of 5 Ncm, which held the abutment at the clockwise rotational endpoint. The standard abutment screw was then tightened to the manufacturer’s specified torque value with the second torque wrench. Angle value corresponding to the clockwise endpoint was measured microscopically between a fixed reference point on the steel plate and the reference arm. The abutment was then unscrewed and removed. The same procedure was carried out to rotate the abutment counterclockwise and measure the angle value corresponding to the counterclockwise rotational endpoint. The rotational freedom was finally determined from the differences in the angles between the clockwise and counterclockwise rotational endpoints. Rotational freedom angle values were summarized as descriptive statistics (means, standard deviations). The normality test (Kolmogorov-Smirnov) was applied, and the Kruskal-Wallis test was performed. The Wilcoxon signed-rank test was used to isolate the implant system differences from each other (α=.05).

RESULTS: The lowest mean rotational freedom angles were obtained for Bone Level (conical connection, 0.17 degrees) and Tapered Screw-Vent (nonconical connection, 0.05 degrees). These systems were followed in increasing order by ID CAM M (conical connection, 0.50 degrees), Seven (nonconical connection, 1.98 degrees), and Naturall+ (conical connection, 2.49 degrees). Compared with each other, all implant systems had significant statistical differences in rotational freedom angles (P<.05).

CONCLUSIONS: Significant differences were found among the 5 implant systems. The lowest mean rotational freedom angles were obtained both with a conical connection (Bone Level) and a nonconical connection (Tapered Screw-Vent).

PMID:34238536 | DOI:10.1016/j.prosdent.2021.04.027

J Laryngol Otol. 2021 Jul 9:1-7. doi: 10.1017/S0022215121001596. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to analyse if there were any associations between patulous Eustachian tube occurrence and climatic factors and seasonality.

METHODS: The correlation between the monthly average number of patients diagnosed with patulous Eustachian tube and climatic factors in Seoul, Korea, from January 2010 to December 2016, was statistically analysed using national data sets.

RESULTS: The relative risk for patulous Eustachian tube occurrence according to season was significantly higher in summer and autumn, and lower in winter than in spring (relative risk (95 per cent confidence interval): 1.334 (1.267-1.404), 1.219 (1.157-1.285) and 0.889 (0.840-0.941) for summer, autumn and winter, respectively). Temperature, atmospheric pressure and relative humidity had a moderate positive (r = 0.648), negative (r = -0.601) and positive (r = 0.492) correlation with the number of patulous Eustachian tube cases, respectively.

CONCLUSION: The number of patulous Eustachian tube cases was highest in summer and increased in proportion to changes in temperature and humidity, which could be due to physiological changes caused by climatic factors or diet trends.

PMID:34238392 | DOI:10.1017/S0022215121001596

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2021 Jun 30;43(3):395-401. doi: 10.3881/j.issn.1000-503X.13752.

ABSTRACT

Objective To evaluate the application value of abbreviated comprehensive geriatric assessment(aCGA)in elderly female breast cancer patients. Methods Eight aspects of the traditional CGA were simplified to form the aCGA assessment table,based on which the patients were classified into three grades of A,B and C according to the total scores.This study enrolled the elderly female patients with breast cancer aged 70 years and above who were treated in PUMC Hospital from June 2018 to January 2020.Eastern Cooperative Oncology Group(ECOG)scoring and aCGA grading were performed respectively,and the results of the two methods were compared. Results Of the 162 patients,111(68.5%)were classified by the aGGA method as grade A,43(26.5%)as grade B,and 8(5.0%)as grade C;131(80.9%)cases have concurrent diseases,and the most common complications were hypertension(n=89),cardiovascular diseases(n=47)and diabetes mellitus(n=39).The ECOG score was 0-1 in 133(82.0%)cases,2 in 24(14.8%)cases and 3 in 5(3.2%)cases.The ECOG score showed 133(82.0%)cases with good status and 29 cases with poor status.However,according to the aCGA classification,111 cases were in good health status and 51 cases were in poor health status;the difference in the result between the two groups was statistically significant(χ ²=14.24,P<0.001).Conclusion Compared with ECOG score,aCGA grading can more comprehensively evaluate the health status of elderly female breast cancer patients and can be applied to the patients aged 70 and above.

PMID:34238415 | DOI:10.3881/j.issn.1000-503X.13752

J Otolaryngol Head Neck Surg. 2021 Jul 8;50(1):44. doi: 10.1186/s40463-021-00525-x.

ABSTRACT

OBJECTIVE: To evaluate the impact of a high efficiency rapid standardized OR (RAPSTOR) for hemithyroid/parathyroid surgery using standardized equipment sets (SES) and consecutive case scheduling (CCS) on turnover times (TOT), average case volumes, patient outcomes, hospital costs and OR efficiency/stress.

METHODS: Patients requiring hemithyroidectomy (primary or completion) or unilateral parathyroidectomy in a single surgeon’s practice were scheduled consecutively with SES. Retrospective control groups were classified as sequential (CS) or non-sequential (CNS). A survey regarding OR efficiency/stress was administered. Phenomenography and descriptive statistics were conducted for time points, cost and patient outcome variables. Hospital cost minimization analysis was performed.

RESULTS: The mean TOT of RAPSTOR procedures (16 min; n = 27) was not significantly different than CS (14 min, n = 14) or CNS (17 min, n = 6). Mean case number per hour was significantly increased in RAPSTOR (1.2) compared to both CS (0.9; p < 0.05) and CNS (0.7; p < 0.05). Average operative time was significantly reduced in RAPSTOR (32 min; n = 28) compared to CNS (48 min; p < 0.05) but not CS (33 min; p = 0.06). Time to discharge was reduced in RAPSTOR (595 min) compared to CNS (1210 min, p < 0.05). There was no difference in complication rate between all groups (p = 0.27). Survey responses suggested improved efficiency, teamwork and workflow. Furthermore, there is associated decrease in direct operative costs for RAPSTOR vs. CS.

CONCLUSION: A high efficiency standardized OR for hemithyroid and parathyroid surgery using SES and CCS is associated with improved efficiency and, in this study, led to increased capacity at reduced cost without compromising patient safety.

LEVEL OF EVIDENCE: Level 2.

PMID:34238389 | DOI:10.1186/s40463-021-00525-x

J Pediatr Endocrinol Metab. 2021 Jul 9. doi: 10.1515/jpem-2021-0023. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare cardiometabolic risk factors of Brazilian children and adolescents with international reference values. Cardiometabolic risk factors constitute the Metabolic Syndrome, whose evaluation is important to assess pediatric populations’ health and potential to experience metabolic disorders.

METHODS: Cross-sectional study that included 2,250 randomly selected children and adolescents (55.6% girls), aged 6 to 17. Cardiometabolic parameters (body mass index [BMI], waist circumference [WC], systolic and diastolic blood pressures [SBP and DBP], total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], TC:HDL-C ratio, triglycerides [TG], glucose and peak oxygen uptake [VO₂peak]), and clustered risk scores were compared to international age- and sex-specific reference values. A clustered risk score was calculated by summing the WC, glucose, SBP, TG, and the TC:HDL-C ratio Z-scores divided by five. A second clustered was calculated including VO₂peak (inverted) Z-score, but divided by six.

RESULTS: The clustered risk score, considering the all ages sample, was better in the Brazilian boys (-0.20 [-0.41;0.01] and -0.18 [-0.37;0.01], including or not VO₂peak, respectively) but not significantly, and worse in girls (0.24 [0.05;0.43] and 0.28 [0.11;0.44], including or not VO₂peak, respectively) than the international reference. Additionally, Brazilian youth had a statistically better profile in TC, LDL-C, HDL-C, TC:HDL-C ratio, and VO₂peak (only girls) as well as a worse profile in BMI, WC, SBP, DBP, TG (only girls), and VO₂peak (only boys).

CONCLUSIONS: The clustered cardiometabolic risk score (including or not VO₂peak), considering the all ages sample, was better in the Brazilian boys, but not significantly, and worse in girls compared to the international reference.

PMID:34237809 | DOI:10.1515/jpem-2021-0023

Drug Metab Pers Ther. 2021 Jul 8. doi: 10.1515/dmdi-2021-0104. Online ahead of print.

ABSTRACT

OBJECTIVES: To mitigate the incidence of recurrent stroke in patients, dual antiplatelet therapy comprising aspirin and clopidogrel is usually administered. Clopidogrel is a prodrug and its bioactivation is catalyzed by cytochrome P450 (CYP)2C19. The main objective of this work was to determine the prevalence of CYP2C19*2 carriers in Saudi ischemic stroke patients and assess the suitability of using genotyping to guide antiplatelet therapy in a university hospital setup.

METHODS: This prospective (2018-2019) study was conducted on 256 patients (age 61 ± 12.5) clinically diagnosed with ischemic stroke who were genotyped using Spartan RX CYP2C19 assay.

RESULTS: From the total patient group (256), upon admission, 210 patients were prescribed either aspirin, clopidogrel or dual antiplatelet therapy. Of the 27 patients with the CYP2C19*2 allele who were prescribed clopidogrel (18) or dual antiplatelet therapy (9), only 21 patients could be followed up for a period of six months post stroke event, in addition to 21 age- and sex-matched patients with the normal allele. The CYP2C19*2 allele carriers had a statistically significant increased risk of recurrent stroke compared to patients carrying the normal allele.

CONCLUSIONS: This study shows the suitability of using genotyping to guide antiplatelet therapy in ischemic stroke patients in a clinical setting.

PMID:34237806 | DOI:10.1515/dmdi-2021-0104