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Τρίτη 7 Ιουνίου 2022

Effectiveness of root canal instrumentation for the treatment of apical periodontitis: A systematic review and meta‐analysis

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Background

The development of endodontic instruments has rapidly advanced but their impact on endodontic outcome parameters remain unclear.

Objectives

This systematic review aimed to answer the following PICOT questions:

In patients with apical periodontitis (P) what is the effectiveness of root canal instrumentation [(Q1) performed with contemporary techniques (I) in comparison with "traditional" techniques (C)] and [(Q2) performed with contemporary engine-driven NiTi instruments (I) compared with other types of contemporary engine-driven NiTi instruments (with different design and/or technology) (C)] in terms of clinical and patient-related outcomes (O)?

Methods

After PROSPERO protocol registration, a literature search was conducted using Clarivate Analytics' Web of Science, Scopus, PubMed, and Cochrane Central Register of Controlled Trials. Grey literature and major journal contents were examined. Two independent reviewers performed the study selection, data extraction, and appraisal of included studies. A quantitative meta-analysis was considered and statistical heterogeneity and overall quality of evidence were assessed.

Results

Nine studies were identified showing substantial methodological differences. Five studies addressed PICOT 1 and three PICOT 2, whereas one study aimed both. A random-effects meta-analysis model was considered for the outcome "radiographic evidence of normal periodontal ligament space or reduction of apical lesion size" (PICOT 1) based in three studies with 332 evaluable participants and showed that contemporary instrumentation was associated with a more favourable outcome (p= .005) compared to root canal preparation with stainless steel instruments (odds ratio=2.07 [95%-confidence interval=1.25-3.44]) with no evidence of statistical heterogeneity (I2=0%) but low quality of evidence.

Discussion

Albeit a few studies fulfilled eligible criteria, no study had a low risk of bias. Compelling evidence indicating significantly different outcome rates using different endodontic instruments when treating teeth with apical periodontitis is lacking.

Conclusions

In terms of healing, the results of the meta-analysis determined the higher effectiveness of root canal instrumentation performed with contemporary techniques in comparison with conventional stainless steel instruments in patients with apical periodontitis followed for a minimum of 1 year with low quality of evidence. No differences could be demonstrated between preparations with traditional stainless steel and contemporary NiTi instruments for other clinical and patient-related outcomes.
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Δευτέρα 6 Ιουνίου 2022

Gestational hypertensive disorders and maternal breast cancer risk in a nationwide cohort of 40,720 parous women

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Background: Pre-eclampsia and gestational hypertension are hypothesized to be associated with reduced maternal breast cancer risk, but the epidemiologic evidence is inconclusive. Our objective was to examine associations between gestational hypertensive disorders and breast cancer in a nationwide cohort of women with a family history of breast cancer. Methods: Women ages 35-74 years who had a sister previously diagnosed with breast cancer, but had never had breast cancer themselves, were enrolled in the Sister Study from 2003-2009 (N=50,884). At enrollment, participants reported diagnoses of eclampsia, pre-eclampsia, or gestational hypertension in each pregnancy. We used Cox proportional hazards models to estimate HRs and 95% CIs for the association between history of a gestational hypertensive disorder and incident invasive breast cancer or ductal carcinoma in situ among 40,720 parous women. We used age as the time scale and adjusted for birth cohort, race–ethnicity, and reproductive, socioeconomic, and behavioral factors. We examined effect measure modification by risk factors for gestational hypertensive disease and breast cancer and assessed possible etiologic heterogeneity across tumor characteristics. Results: The prevalence of gestational hypertensive disease was 12%. During follow-up (mean=10.9 years), 3198 eligible women self-reported a breast cancer diagnosis. History of a gestational hypertensive disorder was not associated with breast cancer risk (HR=1.0, 95% CI 0.90, 1.1). We did not observe clear evidence of effect measure modification or etiologic heterogeneity. Conclusions: History of a gestational hypertensive disorder was not associated with breast cancer risk in a cohort of women with a first-degree family history of breast cancer. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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Κυριακή 5 Ιουνίου 2022

Reliable fluorescence technique to detect the antibiotic colistin, a possible environmental threat due to its overuse

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The clinical and bioinformatics analysis for the role of anti‐hypertension drugs on mortality among patients with hypertension hospitalized with COVID‐19

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Abstract

Comorbidities such as hypertension could exacerbate symptoms of COVID-19 infection. Patients with hypertension may receive both anti-COVID-19 and anti-hypertension therapies when infected with COVID-19. However, it is not clear how different classes of anti-hypertension drugs impact the outcome of COVID-19 treatment. Herein, we explore the association between the inpatient use of different classes of anti-hypertension drugs and mortality among patients with hypertension hospitalized with COVID-19. We totally collected data from 278 patients with hypertension diagnosed with COVID-19 admitted to hospitals in Wuhan from February 01 to April 01, 2020. A retrospective study was conducted and single cell RNA-Seq analysis of treatment-related genes was performed. The results showed that angiotensin II receptor blockers (ARB) and calcium channel blockers (CCB) drugs significantly increased the survival rate but the use of ACEI/beta-block/diuretic drugs did not affec t the mortality caused by COVID-19. Based on the analysis of four public datasets of single-cell RNA-seq on COVID-19 patients, we concluded that JUN, LST1 genes may play a role in the effect of ARB on COVID-19 related mortality while CALM1 gene may contribute to the effect of CCB on COVID-19 related mortality. Our results provide guidance on the selection of anti-hypertension drugs for hypertensive patients infected with COVID-19.

This article is protected by copyright. All rights reserved.
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Τετάρτη 1 Ιουνίου 2022

A novel extracorporeal cardiopulmonary resuscitation strategy using a hybrid emergency room for patients with pulseless electrical activity

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Whether extracorporeal cardiopulmonary resuscitation (ECPR) is indicated for patients with pulseless electrical activity (PEA) remains unclear. Pulmonary embolism with PEA is a good candidate for ECPR; however...
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Effect and Mechanism of the Lenvatinib@H-MnO2-FA Drug Delivery System in Targeting Intrahepatic Cholangiocarcinoma

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Mechanistic and biologically based models in epidemiology; a powerful underutilized tool

alexandrossfakianakis shared this article with you from Inoreader
Abstract
Mechanistic and biologically based mathematical models of chronic and behavioral disease processes aim to capture the main mechanistic or biological features of the disease development, and to connect these with epidemiological outcomes. These approaches have a long history in epidemiological research and are complementary to traditional epidemiological or statistical approaches to investigate the role of risk factor exposures on disease risk.In the article by Simonetto et al. (Am J Epidemiol. XXXX;XXX(XX):XXXX–XXXX)), the authors present a mechanistic, process-oriented, model to investigate the role of smoking, hypertension and dyslipidemia on the development of atherosclerotic lesions and their progression to myocardial infarction (MI). Their approach builds on and brings to cardiovascular disease the ideas and perspectives of earlier mechanistic and biologically based models for the epidemiology of cancer and other chronic diseases, providin g important insights into the mechanisms and epidemiology of smoking related MI.We argue that although mechanistic modeling approaches have demonstrated their value and place in epidemiology, they are highly underutilized. We call for efforts to grow mechanistic and biologically based modeling research, expertise and awareness in epidemiology, including the development of training and collaboration opportunities to attract more students and researchers from STEM areas into the epidemiology field.
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