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In Vitro Effect of Instrumentation Using Ultrasonication with and without Hydrogen Peroxide on the Removal of Biofilms and Spread of Viable Microorganisms in Aerosols

Oral Health Prev Dent. 2022 Jan 20;20(1):11-17. doi: 10.3290/j.ohpd.b2395059.

ABSTRACT

PURPOSE: To evaluate the use of hydrogen peroxide as an adjunct to ultrasonication (US) in biofilm removal and whether it can limit the spread of viable microorganisms in the aerosol.

MATERIALS AND METHODS: Multi-species biofilms were formed on dentin disks and titanium disks fixed on a plastic surface. After placing the specimens in a periodontal pocket model, an ultrasonic scaler was applied for 30 s, in part combined with 0.25% or 0.5% H2O2. After treatment, the remaining biofilm was analysed for bacterial counts (colony forming units [CFU]), biofilm quantity and metabolic activity. Further, the cytotoxic effect of hydrogen peroxide on periodontal ligament fibroblasts was assessed and the spread of bacteria in aerosol was quantified.

RESULTS: Ultrasonication reduced bacterial counts in biofilm, biofilm mass and metabolic activity on both dentin and titanium disks. Adjunctive use of 0.25% and 0.5% H2O2 more effectively reduced the viable bacteria in biofilm than ultrasonication alone; this was also found on both dentin and titanium. The different concentrations of H2O2 did not lead to corresponding differences in bacterial mass and metabolic activity. The spread of bacteria through aerosols was statistically significantly reduced when adjunctive H2O2 was used. However, a certain cytotoxic effect on periodontal ligament fibroblasts by H2O2 could not be ruled out.

CONCLUSIONS: Irrigating with H2O2 during periodontal instrumentation with an ultrasonic scaler increases the reduction of viable bacteria within biofilms. It might limit bacterial spreading via aerosols.

PMID:35049248 | DOI:10.3290/j.ohpd.b2395059

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Monitoring the Sequential Organ Failure Assessment score in nonocclusive mesenteric ischemia increases the survival rate: A single-center observational study

Medicine (Baltimore). 2021 Dec 3;100(48):e28056. doi: 10.1097/MD.0000000000028056.

ABSTRACT

Several large-scale studies have assessed the endovascular and surgical treatments for nonocclusive mesenteric ischemia (NOMI); nonetheless, the prognostic factors for NOMI remain unclear.In this single-center study, we retrospectively reviewed the electronic medical records of 197, 149 patients were retrieved from the inpatient database of our hospital from January 2011 to January 2020; 79 patients with NOMI were observed. A total of 44 patients who underwent laparotomy were statistically analyzed and divided into the survivor and non-survivor groups. Prognostic factors were compared between the 2 groups. Exploratory laparotomy based on a second-look surgery was the first treatment choice.The overall mortality rate was 61.3%, with a male-to-female ratio of 1.6:1. The median Sequential Organ Failure Assessment (SOFA) score was 11.06 [5.75-17.25]. The median SOFA score was 5 [interquartile range: 3-8] in the survivor group and 14.8 [interquartile range: 10.5-19] in the non-survivor group. The log-rank test showed a significant difference in the presence of diabetes mellitus (P = .025), hypoglycemia (P = .001), SOFA score ≥10 (P < .001), hemoglobin levels ≥11 g/dL (P = .003), platelet count ≥12.9 × 104/μL (P = .01), lactate levels ≥2.6 mmol/L (P = .005), and base excess <-3.0 (P < .023). Multivariate analysis using the factors with significant differences revealed that SOFA score ≥10 (hazard ratio for death, 1.199; 95% confidence interval, 1.101-1.305; P < .001) was an independent prognostic factor.The SOFA score can be used to assess disease severity. A SOFA score of ≥10 may be associated with increased mortality.

PMID:35049224 | DOI:10.1097/MD.0000000000028056

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Risk factors for anterior communicating artery aneurysm rupture: A protocol for systematic review and meta-analysis

Medicine (Baltimore). 2021 Dec 3;100(48):e28088. doi: 10.1097/MD.0000000000028088.

ABSTRACT

BACKGROUND: Although the research on the risk factors of anterior communicating artery (AComA) aneurysm has made great progress, the independent effect of each risk factor on the rupture of AComA aneurysm is controversial among different studies. We will perform a protocol for systematic review and meta-analysis to investigate risk factors for AComA aneurysm rupture and quantify their independent effects.

METHODS: A systematic search according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guidelines in PubMed, Embase, and the Cochrane Library databases was conducted from inception to August 31, 2021 for published studies concerning risk factors for AComA aneurysm rupture. In the absence of statistical heterogeneity (ie, P > .10 and I2 < 50%), we will use a fixed-effects model to pool the results across sufficient studies. Otherwise, we will present the results employing the random-effects model. Quality assessment of the included studies will be evaluated using the Newcastle-Ottawa Scale. Statistical analyses will be performed using Stata16 (Stata Corporation, College Station, TX, USA) software.

RESULTS: The findings of this study will be submitted to peer-reviewed journals for publication.

CONCLUSION: This systematic review will provide evidence to determine the risk factors that affect the rupture of the AComA aneurysm and quantify their independent effects.

ETHICS AND DISSEMINATION: Since the proposed study uses pre-published data, ethical approval is not required.

REVIEW REGISTRATION NUMBER: CRD42021284262. (https://www.crd.york.ac.uk/PROSPERO/).

PMID:35049234 | DOI:10.1097/MD.0000000000028088

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The relationship between the drainage function of inguinal lymph nodes and unilateral pelvic cancer-related lymphedema: A retrospective analysis

Medicine (Baltimore). 2021 Dec 3;100(48):e28051. doi: 10.1097/MD.0000000000028051.

ABSTRACT

The aim of this study was to investigate the relationship between iliolumbar lymph nodes (LNs), inguinal LNs, and unilateral pelvic cancer-related lymphedema by retrospective analysis of lymphoscintigraphy data.Ninety-six patients (3 men and 93 women; mean age, 53.3 ± 11.3 years) with pelvic cancer-related lymphedema were enrolled in this retrospective study. Lymphoscintigraphy was performed at 1 hour and 4 to 6 hours after injection. The visualization of inguinal LNs and iliolumbar LNs were recorded.According to statistical analysis, the display of inguinal LNs in lymphoscintigraphy has a significant negative correlation with ipsilateral lower limb lymphedema (P < .01, r = -0.561). However, there is no correlation between the show of iliolumbar LNs and ipsilateral lower extremity lymphedema (P = .056, r = -0.138). When lymphoscintigraphy was performed at 1 hour after injection, there were 13 out of 96 patients without inguinal LNs revealed on imaging, but at 4 to 6 hours after injection, inguinal LNs were seen in lymphoscintigraphy.The drainage function of inguinal LNs has a significant negative correlation with ipsilateral pelvic cancer-related lymphedema. Treatment dedicated to restoring the drainage function of LNs in the inguinal region may effectively relieve lymphedema. The image acquisition at 4 to 6 hours after injection is necessary for significant additional information.

PMID:35049221 | DOI:10.1097/MD.0000000000028051

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The effects of a pharmacist-led medication review in a nursing home: A randomized controlled trial

Medicine (Baltimore). 2021 Dec 3;100(48):e28023. doi: 10.1097/MD.0000000000028023.

ABSTRACT

BACKGROUND: In this study, an intensive review of pharmaceutical care for elderly patients was conducted in a Veterans Administration nursing home in Taiwan and its effects were evaluated.

METHODS: One hundred participants were enrolled in this randomized controlled study with even distribution. The inclusion criteria were age 65 years or older, prescriptions for at least 5 oral medicines daily, and ≥2 chronic diseases, for the period May 2013 to October 2014. Subjects were excluded if they had previously been included in an intensive medication review conducted by a pharmacist. The primary outcomes were numbers of drugs prescribed, potential inappropriate medications, and numbers of drug-related problems. The secondary outcomes were self-reported medical usages, measurements of quality of life, results of a satisfaction survey, and health status.

RESULTS: A total of 80 cases (42 in the intervention group with medication reconciliation and 38 in the control group without medication reconciliation) completed the study. Baseline characteristics were not statistically different between the 2 groups. The overall prevalence of potential inappropriate medication was 74.3%. There were no differences between the 2 groups, with the exception of “medical problems,” which showed a significantly higher prevalence in the intervention group (P < .05). The intervention group reported greater satisfaction regarding pharmacist visits and medication compliance (P < .01). The mean number of drug-related problems was significantly lower after the intervention (P < .01).

CONCLUSION: In this study, the intensive review of the elderly patients’ medications revealed that the only significant effect of pharmaceutical care was on “all outcomes.” A possible reason for this is the rather advanced ages of some patients who needed a considerable number of medications to treat several chronic diseases. Another reason may be the small sample size. However, participants who received the pharmacist intervention did have higher satisfaction with medication reconciliation and fewer drug-related problems.

PMID:35049214 | DOI:10.1097/MD.0000000000028023

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Acupuncture combine with Tuina for diabetic peripheral neuropathy: A protocol for a systematic review and meta-analysis

Medicine (Baltimore). 2021 Dec 3;100(48):e28042. doi: 10.1097/MD.0000000000028042.

ABSTRACT

BACKGROUND: Diabetic peripheral neuropathy (DPN) is one of the most common microvascular complications of diabetes mellitus, with an incidence ranging from 60% to 90%. With the change in modern dietary structure, the incidence of diabetes is increasing year by year, and DPN is also on the rise. Acupuncture and Tuina treatments are often combined to treat DPN; however, there has been no meta-analysis on their synergistic effect; therefore, we aimed to perform a systematic review and meta-analysis to estimate the effectiveness of acupuncture combined with Tuina in DPN treatment.

METHODS: Nine electronic databases were retrieved for this study. The English databases mainly retrieved PubMed, Web of Science, Embase, AMED, and the Cochrane Library, while the CNKI, VIP, CBM, and Wanfang databases were used to retrieve the Chinese literature; there was no definite time limit for the retrieval literature, and the languages were limited to Chinese and English. We will consider articles published between database initiation and November 2021. We used Review Manager 5.4 software provided by the Cochrane Collaborative Network for statistical analysis. We then assessed the quality and risk of the included studies and observed the outcome measures.

RESULTS: This study provides a high-quality synthesis to assess the effectiveness and safety of acupuncture combined with Tuina for treating DPN.

CONCLUSION: This systematic review provided evidence to determine whether acupuncture combined with Tuina is an effective and safe intervention for patients with DPN.

ETHICS AND DISSEMINATION: The protocol for this systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences.

SYSTEMATIC REVIEW REGISTRATION: INPLASY2021110017.

PMID:35049219 | DOI:10.1097/MD.0000000000028042

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Efficacy and safety of Yangxue Qingnao granules for the treatment of essential hypertension: A protocol for systematic review and meta-analysis

Medicine (Baltimore). 2021 Dec 3;100(48):e27911. doi: 10.1097/MD.0000000000027911.

ABSTRACT

BACKGROUND: Essential hypertension is a major risk factor for many fatal cardiovascular and cerebrovascular diseases and has become a heavy burden on families and society. At present, the prevention and treatment of essential hypertension is still unsatisfactory. Yangxue Qingnao granules is a kind of Chinese patent medicine that has been used to treat essential hypertension. The objective of this protocol is to systematically evaluate the efficacy and safety of Yangxue Qingnao granules in the treatment of essential hypertension.

METHODS: Randomized controlled trials on Yangxue Qingnao granules for essential hypertension will be searched from the following databases: PubMed, EMbase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, China Science and Technology Journal Database, and China Biology Medicine disc from inception to August 27, 2021, regardless of language. Study screening and data extraction will be carried out by two independent reviewers. The quality of the included studies will be assessed using Cochrane risk-of-bias tool for randomized trials. Statistic analysis will be performed using RevMan 5.3 software. The quality of evidence will be assessed using GRADE approach.

RESULTS: This study will systematically evaluate the efficacy and safety of Yangxue Qingnao granules in the treatment of essential hypertension and provide high-quality evidence for clinical practice.

CONCLUSION: The findings of this systematic review will provide high-quality evidence to verify the efficacy and safety of Yangxue Qingnao granules in the treatment of essential hypertension.

INPLASY REGISTRATION NUMBER: INPLASY202190015.

PMID:35049194 | DOI:10.1097/MD.0000000000027911

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Prevalence and risk factors associated with repeat positive SARS-CoV-2 nucleic acid test results among discharged COVID-19 patients: A protocol for systematic review and meta-analysis

Medicine (Baltimore). 2021 Dec 3;100(48):e27933. doi: 10.1097/MD.0000000000027933.

ABSTRACT

BACKGROUND: The COVID-19 (coronavirus disease 2019) pandemic continues to have an immense impact on the world at large. COVID-19 patients who meet the discharge criteria, may subsequently exhibit positive viral RNA test results upon subsequent evaluation. This phenomenon has been a major source of research and public health interest, and poses a major challenge to COVID-19 prevention, treatment, and standardized patient management.

METHODS: We will search the PubMed, MEDLINE, Embase, Cochrane Clinical Trials Database, China National Knowledge Infrastructure, Wanfang Database, Chinese Science Journal Database, and China Biology Medicine databases for all studies published as of November 2021. Data will be extracted independently by two researchers according to the eligibility criteria. Finally, RevMan 5.3.0 will be implemented for statistical analyses.

RESULTS: The results of this study will show the prevalence and risk factors associated with repeat positive SARS-CoV-2 nucleic acid test results among discharged COVID-19 patients.

CONCLUSIONS: This study will provide a reliable evidence-based for the prevalence and risk factors associated with repeat positive SARS-CoV-2 nucleic acid test results among discharged COVID-19 patients.

TRIAL REGISTRATION NUMBER: CRD42021272447.

PMID:35049197 | DOI:10.1097/MD.0000000000027933

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Ranibizumab and conbercept for treating wet age-related macular degeneration in China: A systematic review and meta-analysis

Medicine (Baltimore). 2021 Dec 3;100(48):e27774. doi: 10.1097/MD.0000000000027774.

ABSTRACT

BACKGROUND: This study aimed to evaluate the therapeutic effects of ranibizumab and conbercept on wet age-related macular degeneration.

METHODS: Randomized controlled trials comparing ranibizumab and conbercept in the treatment of wet age-related macular degeneration were searched in the PubMed, Medline, EMbase, Cochrane Library, China National Knowledge Infrastructure, Wanfang databases, and Weipu Journal. Two reviewers independently extracted the data and assessed the methodological quality. Data analysis was performed using Rev Man 5.3 software for statistical analysis.

RESULTS: A total of 16 randomized controlled trials, including 1018 patients, were included, and the results showed that the effect of ranibizumab on uncorrected visual acuity was not significantly different from that of conbercept (Mean difference [MD] = -.03, 95% Confidence interval [CI] [-.10-.05], P = .47), and there was no significant difference between the two drugs in the effect on best-corrected visual acuity (MD = .00, 95% CI [-.02-.03], P = .73). The effect of conbercept on intraocular pressure was better than that of ranibizumab (MD = 1.61, 95% CI [1.05-2.17], P < .001). The effect of ranibizumab on central macular thickness was not significantly different from that of conbercept (MD = 1.31, 95% CI [-3.81-6.43], P = .62). Conbercept had a better inhibitory effect on choroidal neovascularization than ranibizumab (MD = .49, 95% CI [.32-.76], P = .001).

CONCLUSION: The effects of ranibizumab on uncorrected visual acuity, best corrected visual acuity, and central macular thickness were not significantly different from those of conbercept. Conbercept is associated with a lower risk of increased intraocular pressure and regression of choroidal neovascularization compared with ranibizumab.

PMID:35049171 | DOI:10.1097/MD.0000000000027774

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Trends and projections in cutaneous melanoma death in the Netherlands from 1950 to 2045

Medicine (Baltimore). 2021 Dec 3;100(48):e27784. doi: 10.1097/MD.0000000000027784.

ABSTRACT

Child sun protection has recently been linked to the future disappearance of fatal melanoma in adults in successive generations. In the Netherlands, however, mortality rates from melanoma have increased gradually from the 1950s, with some indication of stabilisation since 2010, which may be compatible with a birth cohort effect by sun-protective measures and screening. To study the trajectories ahead a trend analysis was applied. Numbers of people with cutaneous melanoma as underlying cause of death from 1950 to 2018 and population data were derived from Statistics Netherlands. A graphical approach was used to explore trends in mortality by age, calendar period, and cohorts born in the successive periods of 1889 to 1979. Age-period-cohort modelling outcomes and population forecasts provided projections of mortality until 2045. Based on 24,151 cases of melanoma death (13,256 men, 10,895 women), age-standardised mortality rates were similar from 1950 to 1989 for both genders, and increased thereafter more in men. The age-curve patterns changed gradually towards higher death rates at older age, implying the existence of a birth cohort effect. The age-period-cohort models showed an increase in melanoma mortality rates in successive generations. For women, the birth cohort effect plateaued for generations born since the mid-1980s. The projected total mortality number was predicted to rise in the next 3 decades.It is concluded that a small future decline of mortality in younger generations can be expected in the Netherlands, but mortality is still rising for the total population.

PMID:35049174 | DOI:10.1097/MD.0000000000027784