Subgingival Air Polishing in Supportive Periodontal Therapy

a.lsfakia shared this article with you from Inoreader Retrospective Analysis of the Long Term Effect of Subgingival Air Polishing in Supportive Periodontal Therapy Via Journal of Clinical Periodontology Abstract Aim Glycine powder air polishing (GPAP) procedure has become popular. Aim of the analysis was to compare the clinical outcomes during supportive periodontal therapy (SPT) of subgingival application of GPAP with those using sole conventional mechanical debridement (SC). Material and Methods Over a median SPT period of 5.3 years (re‐evaluation through last observation), the GPAP‐cohort (n=263) received supra‐and subgingival biofilm removal with GPAP. Supragingival calculus was removed using curets and sonic scalers here. Patients in the SC‐cohort (n=264) were treated with sonic scalers, curets and rubber cup polishing only. Changes in i.e. pocket probing depth (PPD) and furcation involvement were assessed retrospectively. A bootstrapping equivalence testing method in line with the principle of the two one‐sided tests (TOST) procedure was used to compare clinical outcomes. Results The GPAP procedure was statistically equivalent to SC regarding the number of sites with stable PPDs (83.3%; IQR 68.8%, 91.0% vs. 84.0%; IQR 77.8%, 90.0%). However, in the GPAP‐cohort, a trend towards deterioration in furcation status (no equivalence) was noted. Conclusions In periodontal maintenance, the use of GPAP instead of mechanical plaque removal does not improve the clinical outcome. It seems to be contraindicated to treat furcation defects with GPAP only. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Four Hours Postoperative Mobilization is Feasible After Thoracoscopic Anatomical Pulmonary Resection.

a.lsfakia shared this article with you from Inoreader Four Hours Postoperative Mobilization is Feasible After Thoracoscopic Anatomical Pulmonary Resection. Via World Journal of Endocrine Surgery Four Hours Postoperative Mobilization is Feasible After Thoracoscopic Anatomical Pulmonary Resection. World J Surg. 2020 Oct 23;: Authors: Nakada T, Shirai S, Oya Y, Takahashi Y, Sakakura N, Ohtsuka T, Kuroda H Abstract BACKGROUND: We aimed to analyze the feasibility and risk factors associated with early mobilization (EM) within 4 h after thoracoscopic lobectomy and segmentectomy. METHODS: This study retrospectively evaluated 214 consecutive patients who underwent thoracoscopic anatomical pulmonary resection using our EM protocol between October 2017 and February 2019. We compared the correlations of the patients' characteristics including the total number of drugs and perioperative parameters such as air leak, and orthostatic hypotension (OH) between the EM (E group) and failed EM (F group) groups. Second, we evaluated risk factors for OH, which often causes critical complications. RESULTS: A total of 198 patients (92.5%: E group) completed the EM protocol, whereas 16 patients did not (7.5%: F group). The primary causes of failure were severe pain, air leak, postoperative nausea and vomiting, and OH (n = 1, 3, 8, and 4). Upon univariate analysis, air leakage, OH, and non-hypertension were identified as risk factors for failed EM (all p <0.05). EM was associated with a shortened chest tube drainage period (p <0.01). Thirty patients (14%) experienced OH, and 20% of them failed EM. A total number of drugs ≥5 (p = 0.015) was an independent risk factor for OH. Operative and anesthetic variables were not associated with EM or OH. CONCLUSIONS: The EM protocol was safe and useful for tubeless management. Surgeons should be advised to actively prevent air leak. Our EM protocol achieved a low frequency of OH in mobilization. Due to its versatility, our mobilization protocol may be promising, especially in patients without severe comorbidities. Clinical registration number: The study protocol was approved by the Review Board of Aichi Cancer Center (approval number: 2020-1-067). PMID: 33098011 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of household vinegar on calculus removal and mechanical properties of orthodontic resin

a.lsfakia shared this article with you from Inoreader Impact of household vinegar on calculus removal and mechanical properties of orthodontic resin Via Latest Results for Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Abstract Purpose This study evaluated calculus removal efficacy of household vinegar and its effect on autopolymerizing orthodontic resin following repeated immersion. Methods A total of 72 sectioned specimens of orthodontic retainers with calculus deposits following cleaning with the help of immersion in vinegar of different dilutions between 12.5% and 100%, tap water, effervescent tablets, and mechanical debridement were digitally analyzed. Changes in Ca and Fe ions in vinegar were assessed by atomic emission spectroscopy (AES). For mechanical testing, autopolymerizing polymethyl methacrylate (PMMA) samples were similarly grouped and immersed for 78 cycles and their flexural strength and hardness measured. Fourier-transform infrared spectroscopy (FTIR) was performed to evaluate changes in their chemical composition. One-way analysis of variance (ANOVA) and Tukey's test were used to analyze the differences in the mean flexural strength and hardness between the groups (p ≤ 0.05). Results A minimum immersion of 2 h in 25% vinegar solution combined with brushing attained efficiency of 74.13 ± 22% calculus removal. Whereas, tap water and effervescent tablets had 15% and 49% efficiency, respectively. AES results showed diffusion of Ca ions from calculus into the vinegar solution as a plausible mechanism for its structural weakening and removal. Results of mechanical testing showed that undiluted vinegar solution affected the flexural strength of PMMA and this effect was significantly different from that of the effervescent tablets and the remaining vinegar concentrations. There was no significant difference in hardness between the groups. The FTIR showed no changes in the chemical composition of PMMA samples following repeated immersions. Conclusion Vinegar can be useful in the removal of calculus from dental appliances but should be used in diluted forms to minimize side effects. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ablative laser surgery for allergic tattoo reactions: a retrospective study

a.lsfakia shared this article with you from Inoreader Ablative laser surgery for allergic tattoo reactions: a retrospective study Via Latest Results Abstract Patients with allergic tattoo reactions are burdened with itch and have a reduced quality of life. Conservative treatment is often insufficient and little is known about treatment options to remove the responsible allergen. We aimed to address the effectiveness and safety of ablative laser therapy including measurement of patient's satisfaction, in patients with allergic reactions to tattoos. A retrospective study was conducted including patients with allergic tattoo reactions who were treated with a 10,600 nm ablative CO2 laser, either by full-surface ablation or fractional ablation. Clinical information originated from medical files and a 25-item questionnaire. Sixteen tattoo allergy patients were treated with a CO2 laser between January 2010 and January 2018. Fourteen patients completed the questionnaire. Ten patients were satisfied with laser treatment. On a visual analogue scale, pruritus and burning improved with a median of 5.5 and 4 points in the full surface ablation group and 3 points on both parameters in the fractional ablation group. Despite the relatively small group of patients, our results suggest that CO2 laser ablation improves itching, burning and impact on daily life in tattoo allergy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Validation of the Binocular Vision Dysfunction Questionnaire (BVDQ)

a.lsfakia shared this article with you from Inoreader Validation of the Binocular Vision Dysfunction Questionnaire (BVDQ) Via Otology & Neurotology - Published Ahead-of-Print Objective: Among patients presenting with dizziness, visual dysfunction must be considered, including vertical heterophoria (VH), a frequently under-identified form of binocular vision dysfunction where there is vertical discrepancy between the lines of sight of the eyes when at physiologic rest. Current self-rated screening measures do not account for complex VH symptomatology including dizziness/ambulation difficulties, nausea, headache, anxiety, neck pain, and reading impairment. VH must be differentiated from vestibular/otolithic etiologies, as their treatment frequently provides inadequate relief, yet treatment of the VH can reduce/eliminate symptoms. The objective of this study is to create a valid measurement tool (binocular vision dysfunction questionnaire) to assist in identifying VH among dizzy patients to aid in appropriate referral. Study Design: Retrospective case series. Setting: Tertiary referral center. Patients: One hundred twenty-six patients presenting to an optometric binocular vision subspecialist diagnosed with VH. Intervention: Psychometric study. The measurement tool's internal consistency and test–retest reliability was assessed. Confirmatory and exploratory factor analyses were performed. Validity was estimated through correlations with a visual analog scale and validated instruments for headaches, dizziness, and anxiety. Main Outcome Measures/Results: Excellent reliability demonstrated including Cronbach's alpha of 0.91 and high test–retest reliability. Statistical correlations with established measurements established sound convergent/content validity. Analysis of participants who underwent treatment indicated change in BVDQ score correlates with perception of change in symptom burden. Conclusions: Results suggest the BVDQ is a valid, reliable screening tool to assist otologists in identifying VH among their dizzy patients. The BVDQ may also be useful for measuring changes with various treatments, and in identifying diverse symptoms associated with BVD/VH Address correspondence and reprint requests to Mark S. Rosner, M.D., 2550 South Telegraph Road, Suite 100, Bloomfield Hills, MI 48302; E-mail: DrMark@NVMInstitute.org The authors disclose no conflicts of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://journals.lww.com/otology-neurotology). Copyright © 2020 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Temporal Fine Structure of Background Noise Determines the Benefit of Bimodal Hearing for Recognizing Speech

a.lsfakia shared this article with you from Inoreader The Temporal Fine Structure of Background Noise Determines the Benefit of Bimodal Hearing for Recognizing Speech Via Latest Results for Journal of the Association for Research in Otolaryngology Abstract Cochlear implant (CI) users have more difficulty understanding speech in temporally modulated noise than in steady-state (SS) noise. This is thought to be caused by the limited low-frequency information that CIs provide, as well as by the envelope coding in CIs that discards the temporal fine structure (TFS). Contralateral amplification with a hearing aid, referred to as bimodal hearing, can potentially provide CI users with TFS cues to complement the envelope cues provided by the CI signal. In this study, we investigated whether the use of a CI alone provides access to only envelope cues and whether acoustic amplification can provide additional access to TFS cues. To this end, we evaluated speech recognition in bimodal listeners, using SS noise and two amplitude-modulated noise types, namely babble noise and amplitude-modulated steady-state (AMSS) noise. We hypothesized that speech recognition in noise depends on the envelope of the noise, but not on its TFS whe n listening with a CI. Secondly, we hypothesized that the amount of benefit gained by the addition of a contralateral hearing aid depends on both the envelope and TFS of the noise. The two amplitude-modulated noise types decreased speech recognition more effectively than SS noise. Against expectations, however, we found that babble noise decreased speech recognition more effectively than AMSS noise in the CI-only condition. Therefore, we rejected our hypothesis that TFS is not available to CI users. In line with expectations, we found that the bimodal benefit was highest in babble noise. However, there was no significant difference between the bimodal benefit obtained in SS and AMSS noise. Our results suggest that a CI alone can provide TFS cues and that bimodal benefits in noise depend on TFS, but not on the envelope of the noise. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Low Tenofovir Plasma Exposure in HIV Oral Pre-exposure Prophylaxis Recipients with Gastrointestinal Disorders [Antiviral Agents]

a.lsfakia shared this article with you from Inoreader Low Tenofovir Plasma Exposure in HIV Oral Pre-exposure Prophylaxis Recipients with Gastrointestinal Disorders [Antiviral Agents] Via AAC Accepts: Articles Published Ahead of Print Four pre-exposure prophylaxis (PrEP) users with gastro-intestinal disorders (sleeve gastrectomy, terminal ileitis, celiac disease or chronic diarrhea) and receiving oral tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) were included. Despite a self-reported high adherence, trough plasma tenofovir concentrations (after a supervised intake) were significantly lower than those observed in PrEP recipients without gastrointestinal disorders [21 (±9.1) vs. 138 (±85) ng/mL]. PrEP users with gastrointestinal di sorders may need increased TDF doses or alternative prophylactic measures. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Patients with Erythema Migrans: Characterizing the Impact of Initiation of Antibiotic Therapy Prior to Study Enrollment [Clinical Therapeutics]

a.lsfakia shared this article with you from Inoreader Patients with Erythema Migrans: Characterizing the Impact of Initiation of Antibiotic Therapy Prior to Study Enrollment [Clinical Therapeutics] Via AAC Accepts: Articles Published Ahead of Print Erythema migrans is the most common clinical manifestation of Lyme disease, with concomitant subjective symptoms occurring in ~65% of cases in the USA. We evaluated the impact on 12 particular symptoms of having been started on antibiotic treatment before enrollment for 38 subjects with erythema migrans versus 52 untreated subjects. There were no significant differences in the frequency of having at least one symptom or in the symptom severity score on study entry. However, the frequency of having at least one symptom was significantly greater for those who had received <7 days of antibiotic treatment compared with those who had been treated for ≥7 days (23/24 [95.8%] vs 8/14 [57.1%], p=0.006). In addition, the percentage who were males was significantly lower among the group on treatment compared with the untreated study subjects (13/38 [34.2%] vs 34/52 [65.4%], p=0.005). In conclusion, based on these findings, combining untreated and on-treatment grou ps of patients with erythema migrans for research study analyses may have limitations and, depending on the study objectives, might not be preferred. Additional studies are warranted to better understand the day-to-day impact of antibiotic treatment on the presence, type, and severity of symptoms in patients with early Lyme disease. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

First penicillin-binding protein occupancy patterns for 15 {beta}-lactams and {beta}-lactamase inhibitors in Mycobacterium abscessus [Pharmacology]

a.lsfakia shared this article with you from Inoreader First penicillin-binding protein occupancy patterns for 15 {beta}-lactams and {beta}-lactamase inhibitors in Mycobacterium abscessus [Pharmacology] Via AAC Accepts: Articles Published Ahead of Print Mycobacterium abscessus (Mab) causes serious infections that often require over 18 months of antibiotic combination therapy. There is no standard regimen for the treatment of Mab infections and the multitude of combinations that have been used clinically have had low success rates and high rates for toxicities. With β-lactam antibiotics being safe, double β-lactam and β-lactam/β-lactamase inhibitor combinations are of interest for improving treatment of Mab infections and minim izing toxicity. However, a mechanistic approach for building these combinations is lacking since little is known about which penicillin-binding protein (PBP) target receptors are inactivated by different β-lactams in Mab. We determined the preferred PBP targets of 13 β-lactams and two β-lactamase inhibitors in two Mab strains and identified PBP sequences by proteomics. The Bocillin FL binding assay was used to determine the β-lactam concentrations (IC50) that half-maximally inhibited Bocillin binding. Principal component analysis identified four clusters of PBP occupancy patterns. Carbapenems inactivated all PBPs at low concentrations (0.016-0.5mg/L; cluster 1). Cephalosporins (cluster 2) inactivated PonA2, PonA1, and PbpA at low (0.031-1mg/L; ceftriaxone and cefotaxime) or intermediate concentrations (0.35-16mg/L; ceftazidime and cefoxitin). Sulbactam, aztreonam, carumonam, mecillinam and avibactam (cluster 3) inactivated the same PBPs as cephalosporins , but required higher concentrations. Other penicillins (cluster 4) specifically targeted PbpA at 2-16mg/L. Carbapenems, ceftriaxone and cefotaxime were the most promising β-lactams since they inactivated most or all PBPs at clinically relevant concentrations. These first PBP occupancy patterns in Mab provide a mechanistic foundation for selecting and optimizing safe and effective combination therapies with β-lactams. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ciprofloxacin pharmacokinetics/pharmacodynamics (PKPD) against susceptible and low level resistant Escherichia coli in an experimental ascending urinary tract infection model in mice. [Experimental Therapeutics]

a.lsfakia shared this article with you from Inoreader Ciprofloxacin pharmacokinetics/pharmacodynamics (PKPD) against susceptible and low level resistant Escherichia coli in an experimental ascending urinary tract infection model in mice. [Experimental Therapeutics] Via AAC Accepts: Articles Published Ahead of Print The mouse ascending urinary tract infection model was used to study the pharmacokinetic/pharmacodynamic (PKPD) relationship with effect of ciprofloxacin in treatment s.c. for three days varying doses and dosing intervals against a susceptible Escherichia coli (MIC, 0.032 mg/L). Further, a humanized dose of ciprofloxacin was administered for three days against three E. coli with low level resistance, i.e. MIC' s of 0.06, 0.25 and 1 mg/L, respectively. Against the susceptible isolate ciprofloxacin was highly effective in clearing the urine with daily doses from 10 mg/kg, but the dosing regimen had to be divided in at least two doses for optimal effect. Ciprofloxacin could not clear the urine or kidneys for the low level resistant strains. PKPD correlations with all strains combined showed for AUC24/MIC a slightly higher correlation with effect in urine and kidneys (R2, 0.71 and 0.69, respectively) than the %T>MIC (R2, 0.41 and 0.61, respectively). Equal correlations for the two PKPD indices were found for reduction of colony counts (CFUs) in the bladder tissue, but not even the highest dose of 28 mg/kg x 6 could clear the bladder tissue. In conclusion, ciprofloxacin is highly effective in clearing the urine and kidney tissue for fully susceptible E. coli, while even low level resistance in E.coli obscures this effect. While the effect of ciprofloxacin is mostly AUC/MIC driven against E. coli infection in the urinary tr act, the effect in urine depends on presence of ciprofloxacin in the urine during most of 24 hours. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Molecular evaluation of fluoroquinolone resistance in serial Mycobacterium tuberculosis isolates from individuals diagnosed with multidrug-resistant tuberculosis [Mechanisms of Resistance]

a.lsfakia shared this article with you from Inoreader Molecular evaluation of fluoroquinolone resistance in serial Mycobacterium tuberculosis isolates from individuals diagnosed with multidrug-resistant tuberculosis [Mechanisms of Resistance] Via AAC Accepts: Articles Published Ahead of Print Fluoroquinolones (FQ) are crucial components of multidrug-resistant tuberculosis (MDR TB) treatment. Varying levels of resistance are associated with specific mutations within the Quinolone Resistance Determining Region (QRDR) of gyrA. We sequenced the QRDR from serial isolates of MDR TB patients in the Preserving Effective TB Treatment Study (PETTS) with baseline (FQR) or acquired FQ resistance (FQACQR) using the IonTorrent™ Personal Genome Machine to a depth of 10,000x and rep orted single nucleotide polymorphisms in ≥1% of reads. FQR isolates harbored 15 distinct alleles with 1.3 (max=6) on average per isolate. Eighteen alleles were identified in FQACQR isolates with an average of 1.6 (max=9) per isolate. Isolates from 78% of FQACQR individuals had mutant alleles identified within 6 months of treatment initiation. Asp94Gly followed by Ala90Val were the predominant alleles in initial FQ-resistant isolates. Seventy-seven percent (36/47) of FQACQR group patients had isolates with FQ resistance alleles prior to changes to the FQ component of their treatment. Unlike individuals treated initially with other FQs, none of the 21 individuals treated initially with levofloxacin developed genotypic or phenotypic FQ resistance, although, country of residence is likely a contributing factor since 69% of these individuals were from a single country. Initial detection of phenotypic and genotypic resistance occurred simultan eously for most; however, phenotypic resistance occurred earlier in isolates harboring mixtures of very low-abundance (<1% of reads) alleles while genotypic resistance often occurred earlier for low-level resistance-associated alleles. Understanding factors influencing acquisition and evolution of FQ resistance could reveal strategies for improved treatment success. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.