Previous meta-analyses of root caries incidence and increment studies reported different estimates due to the limited number of studies, heterogeneity and variations in studies included. Currently, ...new publications and approaches to handle heterogeneity are available. This research aims to systematically review and meta-analyse root caries incidence and increment, and use meta-regression to analyse heterogeneity.
PUBMED and EMBASE databases were searched systematically.
Longitudinal studies on root caries incidence and increment, published in English language prior to 2017, were independently checked by two authors. A pooled incidence and increment of decayed/filled root surfaces (DFS) was estimated and meta-regression analysis was performed by length of follow-up (<2 years; 2years; 3–4years and ≥5years) and study type (observational population-based and clinical trial).
Of 737 articles, 20 were included for meta-analysis. The annualised root caries incidence and increment were 18.25%CI = 13.22%–23.28% and 0.45CI = 0.37–0.53 root DFS respectively. Length of follow-up influenced the estimates, but not the study type. The annual root DFS incidence and increment from studies <2years were 32.95%CI = 29.13%–36.77% and 0.64CI = 0.38–0.89 root surfaces respectively. Studies with 5+years follow-up, the annualised root caries incidence and increment were 9.4%CI = 3.32%–15.48% and 0.43CI = 0.21–0.64 root surfaces respectively.
Length of follow-up influenced root caries estimates due to a bias towards relatively healthier older adults retained in the study. Root caries increased over time even among the healthier older adults.
The increase in root caries, even among the healthier older adults, should be considered by both clinicians and healthcare planners/policy makers in their provision of services.
OBJECT Both endoscopic and microscopic transsphenoidal approaches are accepted techniques for the resection of pituitary adenomas. Although studies have explored patient outcomes for each technique ...individually, none have prospectively compared sinonasal and quality of life outcomes in a concurrent series of patients at the same institution, as has been done in the present study. METHODS Patients with nonfunctioning adenomas undergoing transsphenoidal surgery were assessed for sinonasal function, quality of life, and pain using the Sino-Nasal Outcome Test-20 (SNOT-20), the short form of the Nasal Obstruction Symptom Evaluation (NOSE) instrument, the SF-36, and a headache scale. Eighty-two patients undergoing either endoscopic (47 patients) or microscopic (35 patients) surgery were surveyed preoperatively and at 24-48 hours, 2 weeks, 4 weeks, 8 weeks, and 1 year after surgery. RESULTS Patients who underwent endoscopic and microscopic transsphenoidal surgery experienced a similar recovery pattern, showing an initial increase in symptoms during the first 2 weeks, followed by a return to baseline by 4 weeks and improvement beyond baseline functioning by 8 weeks. Patients who underwent endoscopic surgery experienced better sinonasal outcomes at 24-48 hours (SNOT total p = 0.015, SNOT rhinologic subscale ssRhino p < 0.001), 2 weeks (NOSE p = 0.013), and 8 weeks (SNOT total p = 0.032 and SNOT ssRhino p = 0.035). By 1 year after surgery, no significant differences in sinonasal outcomes were observed between the 2 groups. Headache scales at 1 year improved in all dimensions except duration for both groups (total result 73%, p = 0.004; severity 46%, p < 0.001; frequency 53%, p < 0.001), with 80% of either microscopic or endoscopic patients experiencing improvement or resolution of headache symptoms. Endoscopic and microscopic patients experienced reduced vitality preoperatively compared with US population norms and remained low postoperatively. By 8 weeks after surgery, both groups experienced significant improvements in mental health (13%, p = 0.005) and vitality (15%, p = 0.037). By 1 year after surgery, patients improved significantly in mental health (14%, p = 0.03), role physical (14%, p = 0.036), social functioning (16%, p = 0.009), vitality (22%, p = 0.002), and SF-36 total (10%, p = 0.024) as compared with preoperative measures. There were no significant differences at any time point between the 2 groups for the total SF-36 or for any of the 8 subscales. CONCLUSIONS Patients who underwent either an endoscopic or a microscopic approach experienced the greatest nasal symptoms at 2 weeks postoperatively and exhibited similar time courses of recovery in nasal, headache, and quality of life assessments. Although patients who underwent endoscopic surgery experienced significantly fewer nasal symptoms during the first 8 weeks, by 1 year after surgery, there were no significant differences between the 2 groups.
The importance of completeness of revascularization by percutaneous coronary intervention in patients with multivessel disease is unclear in that there is little information on the impact of ...incomplete revascularization outside of randomized trials. The objective of this study is to compare long-term mortality and subsequent revascularization for percutaneous coronary intervention patients receiving stents who were completely revascularized (CR) with those who were incompletely revascularized (IR).
Patients from New York State's Percutaneous Coronary Interventions Reporting System were subdivided into patients who were CR and IR. Then subsets of IR patients were contrasted with CR patients. Differences in long-term survival and subsequent revascularization for CR and IR patients were compared after adjustment for differences in preprocedural risk. A total of 68.9% of all stent patients with multivessel disease who were studied were IR, and 30.1% of all patients had total occlusions and/or > or =2 IR vessels. At baseline, the following patients were at higher risk: those who were older and those with more comorbid conditions, worse ejection fraction, and more renal disease and stroke. After adjustment for these baseline differences, IR patients were significantly more likely to die at any time (adjusted hazard ratio=1.15; 95% confidence interval, 1.01 to 1.30) than CR patients. IR patients with total occlusions and a total of > or =2 IR vessels were at the highest risk compared with CR patients (hazard ratio=1.36; 95% confidence interval, 1.12 to 1.66).
IR with stenting is associated with an adverse impact on long-term mortality, and consideration should be given to either achieving CR, opting for surgery, or monitoring percutaneous coronary intervention patients with IR more closely after discharge.
Recent reviews have proposed a causal relationship between prolonged breastfeeding and early childhood caries (ECC), but the evidence to date is inconsistent, with few cohort studies and limited ...investigation of key confounders.
This study aimed to investigate the relationship between dietary practices and early childhood caries in a birth cohort of Australian preschoolers.
Participants underwent a standardized dental examination at 2–3 y of age to determine the prevalence of ECC (based on the presence of decayed, missing, or filled tooth surfaces). Breastfeeding practices were reported at 3, 6, 12, and 24 mo of age. Intakes of free sugars were assessed at 1 and 2 y of age. Multivariable regression models generated prevalence ratios (PR) for the association between ECC and breastfeeding duration, and between ECC and sleep feeding practices at 1 y, controlling for sociodemographic factors and free sugars intake.
There was no independent association between breastfeeding beyond 1 y of age and ECC (PR 1.42, 95% CI: 0.85, 2.38), or between breastfeeding to sleep and ECC (PR 1.12, 95% CI: 0.67, 1.88), although the direction of effect was suggestive of an association. The only factors independently associated with ECC were high free sugars intakes (PR 1.97, 95% CI: 1.13, 3.44), and greater socioeconomic disadvantage (PR 2.15, 95% CI: 1.08, 4.28). Most participants who were breastfed at 1 y of age had ceased by 18 mo or 2 y.
Breastfeeding practices were not associated with ECC. Given the wide-ranging benefits of breastfeeding, and the low prevalence of sustained breastfeeding in this study and Australia in general, recommendations to limit breastfeeding are unwarranted, and breastfeeding should be promoted in line with global and national recommendations. To reduce the prevalence of early childhood caries, improved efforts are needed to limit foods high in free sugars.
Humans and dogs commonly share the same domestic environment. Europe, and Italy specifically, have a substantial and growing dog population. Potentially zoonotic parasites may be harbored even by ...dogs receiving regular veterinary care. Thus, transmission of zoonotic or potentially zoonotic parasites to owners and their families should not be underestimated. Frequently, endoparasite infections occur as a subclinical infection and clinicopathological alterations have been documented including anemia, hypoalbuminemia, and eosinophilia. The aim of this large retrospective secondary data study was to analyze coprological endoparasite results and putative risk factors obtained from owned dogs, through a 9-year-period (2011-2019). Possible associations between diagnosed endoparasites and sex, age, seasonality, and year of examination were evaluated. Additionally, parasitological diagnoses were combined to complete blood count parameters and biochemical profiles, when available, to check for any possible hematological alteration from parasitism. A total of 1,972 dogs were evaluated for endoparasites using common fecal diagnostic tests over a 9-year period. The overall proportion of endoparasite-positive animals was 10%. The most common endoparasites detected were Cystoisospora spp. (3%), Toxocara canis (2.8%), Giardia duodenalis (1.6%), and Trichuris vulpis (1.2%). Of these parasites detected, Toxocara poses the greatest zoonotic risk, while Giardia species are considered to have a low potential to be zoonotic. There was no significant diagnostic trend across the years through the study period. Dogs were more frequently diagnosed endoparasite-positive when young and during cold seasons compared to the baselines of mature dogs and warm seasons. The clinicopathological profiles indicated that parasitized dogs had mild hematological alterations. The frequency of detected potentially zoonotic endoparasites in this study highlights that the risk should not be underestimated. Parasitic infection was found to be mostly dependent on age and season. Having this information may help clinicians to develop anthelmintic protocols to reduce the risk of transmission.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Significance In the search for effective multiple sclerosis treatment, much effort has been invested in estrogens and estrogen receptor (ER) agonists because of their neuroprotective benefits. ...However, because estrogens can produce ERα-based feminizing effects and cancer, ERβ agonists represent more desirable therapeutic candidates. The structurally unique ERβ ligand indazole chloride (Ind-Cl), a halogen-substituted phenyl-2H-indazole core, is a preclinical development candidate with a strong dossier. Our results indicate that Ind-Cl is effective in functionally ameliorating disease even when treatment is initiated at peak experimental autoimmune encephalomyelitis clinical disease. Ind-Cl’s immunomodulatory and direct remyelinating effects result in motor dysfunction amelioration. These findings support Ind-Cl's potential to provide unique therapeutic benefits to patients with multiple sclerosis, as well as patients affected by other demyelinating disorders.
Currently available immunomodulatory therapies do not stop the pathogenesis underlying multiple sclerosis (MS) and are only partially effective in preventing the onset of permanent disability in patients with MS. Identifying a drug that stimulates endogenous remyelination and/or minimizes axonal degeneration would reduce the rate and degree of disease progression. Here, the effects of the highly selective estrogen receptor (ER) β agonist indazole chloride (Ind-Cl) on functional remyelination in chronic experimental autoimmune encephalomyelitis (EAE) mice were investigated by assessing pathologic, functional, and behavioral consequences of both prophylactic and therapeutic (peak EAE) treatment with Ind-Cl. Peripheral cytokines from autoantigen-stimulated splenocytes were measured, and central nervous system infiltration by immune cells, axon health, and myelination were assessed by immunohistochemistry and electron microscopy. Therapeutic Ind-Cl improved clinical disease and rotorod performance and also decreased peripheral Th1 cytokines and reactive astrocytes, activated microglia, and T cells in brains of EAE mice. Increased callosal myelination and mature oligodendrocytes correlated with improved callosal conduction and refractoriness. Therapeutic Ind-Cl-induced remyelination was independent of its effects on the immune system, as Ind-Cl increased remyelination within the cuprizone diet-induced demyelinating model. We conclude that Ind-Cl is a refined pharmacologic agent capable of stimulating functionally relevant endogenous myelination, with important implications for progressive MS treatment.
Overseas-trained dentists comprise at least one-fourth of the overall Australian dental workforce. This study examined characteristics and practice differences between Australian- and ...overseas-trained dentists to identify key predictors that best differentiate their dentistry practices.
Data for the study were from the Longitudinal Study of Dentist Practice Activity (LSDPA), a survey of a nationally representative random sample of dentists in Australia commencing in 1983-1984 and repeated every 5 years. Dentists were surveyed on a wide range of items including participant characteristics, practice patterns, practice inputs, direct demand, and productivity measures. Data were weighted to provide national estimates by age, sex, and practice type. Discriminant function analysis was used to examine the predictor variables that best distinguished between the two groups. Analysis was limited to the most recent wave of the study.
A total of 1148 dentists (response rate = 67%) responded to the survey in 2009-2010; 648 cases were available for the discriminant analysis. The discriminant functions for the full sample and each of the 3 age groups (<35 years; 35-50 years; and 50+ years) were found effective to separate dentists into 2 groups (Australian and overseas), with the proportion of cases correctly classified being highest for the oldest age group (89.7% for 50+ years). Female gender, type of practice (working in public sector), and working in disadvantaged areas were significant predictors, with more prominence in the 35- to 50-year age group. Practice inputs, demand, and productivity measures offered less discriminative capacity between the dentists.
Overseas-trained dentists contribute towards providing dental care to underserved populations, the public sector, and in rural and remote locations. This study provided basis to argue that policies to encourage overseas-trained dentists to contribute towards areas of need locations have been successful, and key productivity measures were also similar to Australian-trained dentists.
Magnetic resonance (MR) imaging of the sonographically indeterminate adnexal mass can be used to guide patient care and reduce the costs of investigation and treatment. Most indeterminate masses ...result from common benign conditions, and women with such masses can avoid unnecessary or inappropriate surgery. For the minority of women in whom indeterminate masses are malignant, use of MR imaging rather than a "wait and watch" strategy of interval re-examination with ultrasonography offers a more timely diagnosis. There are simple diagnostic steps in the MR imaging assessment that direct a problem-solving, tailored approach based on signal characteristics and morphology.
Based on the hypothesis that a vicious cycle of dental fear exists, whereby the consequences of fear tend to maintain that fear, the relationship between dental fear, self-reported oral health status ...and the use of dental services was explored.
The study used a telephone interview survey with interviews predominantly conducted in 2002. A random sample of 6,112 Australian residents aged 16 years and over was selected from 13 strata across all States and Territories. Data were weighted across strata and by age and sex to obtain unbiased population estimates.
People with higher dental fear visited the dentist less often and indicated a longer expected time before visiting a dentist in the future. Higher dental fear was associated with greater perceived need for dental treatment, increased social impact of oral ill-health and worse self-rated oral health. Visiting patterns associated with higher dental fear were more likely to be symptom driven with dental visits more likely to be for a problem or for the relief of pain. All the relationships assumed by a vicious cycle of dental fear were significant. In all, 29.2% of people who were very afraid of going to the dentist had delayed dental visiting, poor oral health and symptom-driven treatment seeking compared to 11.6% of people with no dental fear.
Results are consistent with a hypothesised vicious cycle of dental fear whereby people with high dental fear are more likely to delay treatment, leading to more extensive dental problems and symptomatic visiting patterns which feed back into the maintenance or exacerbation of existing dental fear.
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