Nanotechnology has emerged as a groundbreaking field with immense potential to transform various sectors of healthcare, including dentistry. In recent years, its application in periodontal treatment ...has garnered considerable attention from researchers and clinicians. This review explores the current state of nanotechnology in periodontal therapy, discussing its various applications, advantages, challenges, and future prospects. With a focus on advancements in nanomaterials, drug delivery systems, and diagnostic tools, this review aims to provide a comprehensive understanding of how nanotechnology is reshaping the landscape of periodontal treatment.
There is conflicting evidence on association between quick sequential organ failure assessment (qSOFA) and sepsis mortality in ICU patients. The primary aim of this study was to determine the ...association between qSOFA and 28-day mortality in ICU patients admitted for sepsis. Association of qSOFA with early (3-day), medium (28-day), late (90-day) mortality was assessed in low and lower middle income (LLMIC), upper middle income (UMIC) and high income (HIC) countries/regions.
This was a secondary analysis of the MOSAICS II study, an international prospective observational study on sepsis epidemiology in Asian ICUs. Associations between qSOFA at ICU admission and mortality were separately assessed in LLMIC, UMIC and HIC countries/regions. Modified Poisson regression was used to determine the adjusted relative risk (RR) of qSOFA score on mortality at 28 days with adjustments for confounders identified in the MOSAICS II study.
Among the MOSAICS II study cohort of 4980 patients, 4826 patients from 343 ICUs and 22 countries were included in this secondary analysis. Higher qSOFA was associated with increasing 28-day mortality, but this was only observed in LLMIC (p < 0.001) and UMIC (p < 0.001) and not HIC (p = 0.220) countries/regions. Similarly, higher 90-day mortality was associated with increased qSOFA in LLMIC (p < 0.001) and UMIC (p < 0.001) only. In contrast, higher 3-day mortality with increasing qSOFA score was observed across all income countries/regions (p < 0.001). Multivariate analysis showed that qSOFA remained associated with 28-day mortality (adjusted RR 1.09 (1.00-1.18), p = 0.038) even after adjustments for covariates including APACHE II, SOFA, income country/region and administration of antibiotics within 3 h.
qSOFA was independently associated with 28-day mortality in ICU patients admitted for sepsis. In LLMIC and UMIC countries/regions, qSOFA was associated with early to late mortality but only early mortality in HIC countries/regions.
Background
Crohn's perianal fistulas are often refractory to standard management. Fat graft injections are hypothesised to improve fistula healing rates. We evaluated the treatment efficacy of fat ...graft injections for Crohn's perianal fistulas in a systematic review (PRISMA).
Methods
We completed database searches of MEDLINE (Ovid), Embase, and PubMed.
All studies published in English in full text or , from January 2001 to August 2021, evaluating fat graft injections for Crohn's perianal fistulas were selected. Included randomized controlled trials, single‐arm intervention trials, cohort studies, and case series; excluded single case reports. Primary outcome was pooled clinical healing, defined as non‐draining treated fistulas, or closure, defined as closure of treated fistulas. Secondary outcomes were clinical healing, clinical closure, radiologic response, and adverse events.
Results
Of 1258 publications identified, 891 articles were assessed for eligibility, and 107 relevant for manuscript review. Forty‐nine patients received fat graft injections for Crohn's perianal fistulas across four single‐arm intervention trials. Clinical healing or closure was achieved in 74% in a pooled single‐arm meta‐analysis (95% confidence interval: 57%, 85%), with moderate heterogeneity between studies. Clinical healing was achieved in 20% and 60% at 3 and 12 months, respectively. Clinical closure was achieved in 83% at 6 months. Variable parameters were used to define radiologic response, with success rates from 20% to 67%. Minimal adverse events were reported.
Conclusion
Fat graft injections show promise as a novel treatment for Crohn's perianal fistulas in this systematic review and meta‐analysis. Assessment in controlled matched studies is warranted.
We herein evaluated the treatment efficacy of fat graft injections for the treatment of Crohn's perianal fistulas in the first systematic review (PRISMA) of its kind. In 49 patients, across four single‐arm intervention trials, clinical healing or closure was achieved in 74% in a pooled single‐arm meta‐analysis (95% confidence interval; 57%, 85%). Minimal adverse events were reported.
